چكيده به لاتين
Hematopoietic Stem Cells Transplantation (HSCT) is commonly used to treat patients diagnosed by cancers and those suffering from immune system deficiency and many other diseases. Stem cell transplantation is effective when the patient and donor are sufficiently matched in terms of Human leukocyte antigen (HLA) type to increase the chance of successful transplantation. Because health care budgets are limited in all countries, many researchers and government officials are trying to reduce health spending and increase its efficiency. In our country, due to the existing sanctions, the cost of materials, supplies and technologies in the field of treatment is doubly important. Given the demographic characteristics affecting the quality of HSCT and the factors increasing the chance of finding compatible donor-recipient pairs, for the first time, this study presents a framework to simultaneously optimize the donors' ethnic composition and the adult stem cell supply chain network. At first, the Common Weights Data Envelopment Analysis (CWDEA) approach is applied to identify the most efficient candidate areas for collection cells from volunteers. Afterwards, a multi-objective mixed-integer programming model is developed, the first objective of which minimizes the total cost while the second objective maximizes the coverage of phenotypes in various ethnic groups.
Diagnosing the compatibility of the donor and the patient requires performing the HLA typing test which is needed to import the laboratory kits. So it will be heavily influenced by economic sanctions and uncertainty in the real world. To deal with the uncertainty in the problem after presenting the initial model, using the approach of Bertsimas and Sim, the proposed model has converted to robust model. To show the applicability of the proposed model, numerical experiments are presented on the case study conducted on the HLA types belong to the Azeri, Fars and Baluch ethnicities. According to the results, 46 cities were selected as suitable cities for adult stem cell donation and it was found that if the adult stem cells bank be willing to registeration of 100000 new donors, 60% of donors should be selected from the Azeri ethnic group, 31% from the Fars ethnic group and 9% from the Baluch ethnic group to create the maximum chance of finding a compatible donor. Finally, according to the location and network design, we have classified cities into three general groups and provided management strategies for each group. Among the cities surveyed in the network, the cities of Tehran, Esfahan, Shiraz, Kerman, Mashhad, Ahvaz, Bandarabbas, Tabriz, Zanjan, Sarbaz and Khash were identified as the main poles of donation and transplantation of adult stem cells.
