Modelling and simulating the organ donation process using bootstrap and event-driven process chain representation

Transplants improve the quality of life and extend lifespan by replacing damaged organs. The duration of the donor management process must be evaluated and shortened to prevent organ degradation. In this paper, we propose an event-process-chain (EPC) model for the donor management process and conduct a Monte Carlo event-driven simulation to assess its overall duration. We give a rigorous description of the current procedure, to be used as a baseline to re-organize the process. Monte Carlo simulation parameters are based on a measurement campaign where the durations of all the activities in the donor management process have been observed. Due to the low number of donors, we employ a bootstrap approach to generate activity times. We evaluate the overall process completion time and identify the most critical activities. The standard deviation of the completion time is just 11.5% of the mean value. Instrumental tests (encompassing diagnostic and analytical procedures) turn out to be the activities to focus on to shorten the completion time significantly. In order to achieve lower organ degradation, policy guidelines should then address the time of execution (e.g. as to consent acquisition) and the duration of those tests.