An intelligent system for prioritisation of organ transplant patient waiting lists using fuzzy logic

The objective of this paper is to investigate the effectiveness of using fuzzy logic in a complex decision-making capacity, and in particular, for the prioritisation of kidney transplant recipients. Fuzzy logic is an extension to Boolean logic allowing an element to have degrees of true and false as opposed to being either 100% true or 100% false. Thus, it can account for the ‘shades of grey’ found in many real-world situations. In this paper, two fuzzy logic models are developed demonstrating its effectiveness as a model for vastly improving the current prioritisation system used in the UK and abroad. The first model converts an element of the current kidney transplant prioritisation system used in the UK into fuzzy logic. The result is an improvement to the current system and a demonstration of fuzzy logic as an effective decision-making approach. The second model offers an alternative prioritisation system to overcome the limitations of the current system both in the UK and abroad, as brought up by research reviewed in this paper. The current UK transplant prioritisation system, adapted in the first model, uses objective criteria (age of recipient, waiting time, etc) as inputs into the decision-making process. This alternative model takes advantage of the facility for infinitely varying inputs into fuzzy logic and a system is developed that can handle subjective (humanistic) criteria (pain level, quality of life, etc) that are key to arriving at such important decisions. Furthermore, the model is highly flexible allowing any number of criteria to be used and the individual characteristics of each criterion to be altered. The result is a model that utilises the scope of fuzzy logic's flexibility, usability and effectiveness in the field of decision-making and a transplant prioritisation method vastly superior to the original system, which is constrained by its use of only objective criteria. The ‘humanistic’ model demonstrates the ability of fuzzy logic to consider subjective and complex criteria. However, the criteria used are not intended to be exhaustive. It is simply a template to which medical professionals can apply limitless additional criteria. The model is produced as an alternative to any current national system. However, the model can also be used by individual hospitals to decide initially whether a patient should be placed on the transplant or surgery waiting list. The model can be further adapted and used for the transplant of other organs or similar decisions in medicine. Concurrently with the research and work carried out to develop the two models the investigation focused on the constraints of the current systems used in the UK and the US and the seemingly impossible dilemmas experienced by those having to make the prioritisation decisions. By removing the parameters of objective-only inputs the ‘humanistic’ model eradicates the previous limitations on decision-making.