Using a mathematical model to assist with the management of paediatric heart transplant waiting lists: a case study

It is possible to prolong the life of some paediatric patients awaiting heart transplantation using 'bridging' technology, which involves admission to an intensive care environment. It is expected that such bridging reduces deaths on the waiting list and increases the utilization of donor organs. However, bridging offers no guarantee of survival to transplant and can be very burdensome for the families and patients involved. Furthermore, it requires high-level care on a cardiac unit at a large financial and opportunity cost, raising a number of questions concerning its appropriate use. In this work, we explore whether an analytical mathematical model could provide useful insights into the key relationships associated with paediatric cardiac transplant services. We present the framework of an analytical model developed using queuing theory, along with illustrative results based on model parameter estimates derived from retrospective data.