System design and data driven policy simulation for organ procurement networks using an OPO centre operations management framework

Healthcare organ procurement and transplantation function as a multi‑actor operations system in which governance rules and incentive structures shape organisational behaviour and contribute to persistent regional inequities. This study develops a data‑driven, simulation‑based framework for evaluating and redesigning incentive mechanisms within the US Organ Procurement Organization (OPO)–transplant centre network. Using SRTR‑style centre‑level activity data, we construct a Java‑based policy‑simulation environment that models transplant‑centre responses under two governance regimes: a status‑quo environment and a reform regime incorporating equity‑weighted incentive adjustments. Centre utility is formulated from observed transplant volumes, regional characteristics, and operating cost components, while system performance is assessed using aggregate welfare and distributional equity metrics. Simulation experiments reveal quantifiable equity–efficiency trade‑offs and identify parameter regions where moderate incentive redesign improves regional equity with minimal loss in overall system performance. By integrating system design, behavioural response modelling, and incentive analysis, the framework provides regulators with a transparent tool for testing policy reforms and anticipating operational consequences in organ procurement networks.