The Future Supply Chain of Organ Transplantation

Relevance

As I was reading this week's articles on creating your own customized dress shirt or vehicle, the idea of a modern-day flexible supply chain to meet the exact needs of a single customer and what it means for decision-making for executive leadership reminded me of a complementary topic: organ transplantation. The organ transplant market/industry is a very complex space with ever increasing high demand and constant low supply. Some of the main points of this area are bulleted below:

• Never enough organs, always a long list of patients with need
• Regulated heavily based on state and regional policies especially for organ exchanges between states and regions
• Livers and kidneys are hot items
• Organ procurement from a recently deceased individual has a narrow window period to extract the organs before they are no longer viable for transplantation
• Host rejection of donor organ is a huge barrier
• The wait-list of patients is always a controversial topic (http://abcnews.go.com/Health/girl-prompts-small-change-organ-transplant-policy/story?id=19373685)
• A very convoluted process of checks and authorizations exist before the patient is allowed to receive the organ assuming that this patient is on top of the list

UNOS and HRSA-OPTN are excellent sources to get a better understanding of this market.

UNOS

http://www.unos.org/docs/UNOS_FactsFigures.pdf

HRSA-OPTN

http://optn.transplant.hrsa.gov/data/

Of all the bullets I listed, I believe host rejection is one of the most significant issues. Imagine waiting on the list for 4 years for a critical organ need, finally getting that organ, and paying for the surgeon and follow-up services after the transplantation only to find out that your body rejects the organ and you're back at square 1. One potential innovation that could address this problem is the idea of being able to produce personalized organs using the patient's cells via tissue printing (using patient's cells could potentially negate the issue of host rejection since the organ is not seen by the body as something foreign).

http://www.nytimes.com/2013/08/20/science/next-out-of-the-printer-living-tissue.html?pagewanted=all&_r=0

Significance

Personally customized and affordable dress shirts are cool but personally customized organs are a true game-changer. If the technology improves and a portfolio of organs could be manufactured using patient cells within a reasonable cost and production time, the supply shortage and the delivery bureaucracy could be problems of the past.

Question

Let's say you are the COO of the nation's leading hospital that has this capability and we find out that the quickest time to make any organ using patient's cells is 3 months. What type of supply chain system and consumer regulation would you set up for tissue printing to ensure the greatest number of worthy patients are serviced? This is a unique situation since both the hospital and the patient are suppliers (hospital can only supply the organ after the patient supplies the cells). Some things to consider:

• There is a fixed number of tissue production labs 
• How to ensure the lowest turnaround time for cell supply from patient
• How do you determine which patient gets to use tissue printing and which gets to take the chance with the current bank of donated organs
• Tradeoff between need and success: children would gain the greatest value of organ transplants but are usually more complicated cases versus younger adults/adults