Designing the Liver Allocation Hierarchy: Incorporating Equity and Uncertainty

Liver transplantation is the only available therapy for any acute or chronic condition resulting in irreversible liver dysfunction. The liver allocation system in the U.S. is administered by the United Network for Organ Sharing (UNOS), a scientific and educational nonprofit organization. The main components of the organ procurement and transplant network are Organ Procurement Organizations (OPOs), which are collections of transplant centers responsible for maintaining local waiting lists, harvesting donated organs and carrying out transplants. Currently in the U.S., OPOs are grouped into 11 regions to facilitate organ allocation, and a three-tier mechanism is utilized that aims to reduce organ preservation time and transport distance to maintain organ quality, while giving sicker patients higher priority. Livers are scarce and perishable resources that rapidly lose viability, which makes their transport distance a crucial factor in transplant outcomes. When a liver becomes available, it is matched with patients on the waiting list according to a complex mechanism that gives priority to patients within the harvesting OPO and region. Transplants at the regional level accounted for more than 50% of all transplants since 2000.This dissertation focuses on the design of regions for liver allocation hierarchy, and includes optimization models that incorporate geographic equity as well as uncertainty throughout the analysis. We employ multi-objective optimization algorithms that involve solving parametric integer programs to balance two possibly conflicting objectives in the system: maximizing efficiency, as measured by the number of viability adjusted transplants, and maximizing geographic equity, as measured by the minimum rate of organ flow into individual OPOs from outside of their own local area. Our results show that efficiency improvements of up to 6% or equity gains of about 70% can be achieved when compared to the current performance of the system by redesigning the regional configuration for the national liver allocation hierarchy.We also introduce a stochastic programming framework to capture the uncertainty of the system by considering scenarios that correspond to different snapshots of the national waiting list and maximize the expected benefit from liver transplants under this stochastic view of the system. We explore many algorithmic and computational strategies including sampling methods, column generation strategies, branching and integer-solution generation procedures, to aid the solution process of the resulting large-scale integer programs. We also explore an OPO-based extension to our two-stage stochastic programming framework that lends itself to more extensive computational testing. The regional configurations obtained using these models are estimated to increase expected life-time gained per transplant operation by up to 7% when compared to the current system.This dissertation also focuses on the general question of designing efficient algorithms that combine column and cut generation to solve large-scale two-stage stochastic linear programs. We introduce a flexible method to combine column generation and the L-shaped method for two-stage stochastic linear programming. We explore the performance of various algorithm designs that employ stabilization subroutines for strengthening both column and cut generation to effectively avoid degeneracy. We study two-stage stochastic versions of the cutting stock and multi-commodity network flow problems to analyze the performances of algorithms in this context

A Two-Level Approach to Large Mixed-Integer Programs with Application to Cogeneration in Energy-Efficient Buildings

We study a two-stage mixed-integer linear program (MILP) with more than 1 million binary variables in the second stage. We develop a two-level approach by constructing a semi-coarse model (coarsened with respect to variables) and a coarse model (coarsened with respect to both variables and constraints). We coarsen binary variables by selecting a small number of pre-specified daily on/off profiles. We aggregate constraints by partitioning them into groups and summing over each group. With an appropriate choice of coarsened profiles, the semi-coarse model is guaranteed to find a feasible solution of the original problem and hence provides an upper bound on the optimal solution. We show that solving a sequence of coarse models converges to the same upper bound with proven finite steps. This is achieved by adding violated constraints to coarse models until all constraints in the semi-coarse model are satisfied. We demonstrate the effectiveness of our approach in cogeneration for buildings. The coarsened models allow us to obtain good approximate solutions at a fraction of the time required by solving the original problem. Extensive numerical experiments show that the two-level approach scales to large problems that are beyond the capacity of state-of-the-art commercial MILP solvers

Reformulation and decomposition of integer programs

In this survey we examine ways to reformulate integer and mixed integer programs. Typically, but not exclusively, one reformulates so as to obtain stronger linear programming relaxations, and hence better bounds for use in a branch-and-bound based algorithm. First we cover in detail reformulations based on decomposition, such as Lagrangean relaxation, Dantzig-Wolfe column generation and the resulting branch-and-price algorithms. This is followed by an examination of Benders’ type algorithms based on projection. Finally we discuss in detail extended formulations involving additional variables that are based on problem structure. These can often be used to provide strengthened a priori formulations. Reformulations obtained by adding cutting planes in the original variables are not treated here.Integer program, Lagrangean relaxation, column generation, branch-and-price, extended formulation, Benders' algorithm

Optimizing the Efficiency of the United States Organ Allocation System through Region Reorganization

Allocating organs for transplantation has been controversial in the United States for decades. Two main allocation approaches developed in the past are (1) to allocate organs to patients with higher priority at the same locale; (2) to allocate organs to patients with the greatest medical need regardless of their locations. To balance these two allocation preferences, the U.S. organ transplantation and allocation network has lately implemented a three-tier hierarchical allocation system, dividing the U.S. into 11 regions, composed of 59 Organ Procurement Organizations (OPOs). At present, an procured organ is offered first at the local level, and then regionally and nationally. The purpose of allocating organs at the regional level is to increase the likelihood that a donor-recipient match exists, compared to the former allocation approach, and to increase the quality of the match, compared to the latter approach. However, the question of which regional configuration is the most efficient remains unanswered. This dissertation develops several integer programming models to find the most efficient set of regions. Unlike previous efforts, our model addresses efficient region design for the entire hierarchical system given the existing allocation policy. To measure allocation efficiency, we use the intra-regional transplant cardinality. Two estimates are developed in this dissertation. One is a population-based estimate; the other is an estimate based on the situation where there is only one waiting list nationwide. The latter estimate is a refinement of the former one in that it captures the effect of national-level allocation and heterogeneity of clinical and demographic characteristics among donors and patients. To model national-level allocation, we apply a modeling technique similar to spill-and-recapture in the airline fleet assignment problem. A clinically based simulation model is used in this dissertation to estimate several necessary parameters in the analytic model and to verify the optimal regional configuration obtained from the analytic model. The resulting optimal region design problem is a large-scale set-partitioning problem in whichthere are too many columns to handle explicitly. Given this challenge, we adapt branch and price in this dissertation. We develop a mixed-integer programming pricing problem that is both theoretically and practically hard to solve. To alleviate this existing computational difficulty, we apply geographic decomposition to solve many smaller-scale pricing problems based on pre-specified subsets of OPOs instead of a big pricing problem. When solving each smaller-scale pricing problem, we also generate multiple ``promising' regions that are not necessarily optimal to the pricing problem. In addition, we attempt to develop more efficient solutions for the pricing problem by studying alternative formulations and developing strong valid inequalities. The computational studies in this dissertation use clinical data and show that (1) regional reorganization is beneficial; (2) our branch-and-price application is effective in solving the optimal region design problem

Decentralised Optimisation and Control in Electrical Power Systems

Emerging smart-grid-enabling technologies will allow an unprecedented degree of observability and control at all levels in a power system. Combined with flexible demand devices (e.g. electric vehicles or various household appliances), increased distributed generation, and the potential development of small scale distributed storage, they could allow procuring energy at minimum cost and environmental impact. That however presupposes real-time coordination of demand of individual households and industries down at the distribution level, with generation and renewables at the transmission level. In turn this implies the need to solve energy management problems of a much larger scale compared to the one we currently solve today. This of course raises significant computational and communications challenges. The need for an answer to these problems is reflected in today’s power systems literature where a significant number of papers cover subjects such as generation and/or demand management at both transmission and/or distribution, electric vehicle charging, voltage control devices setting, etc. The methods used are centralized or decentralized, handling continuous and/or discrete controls, approximate or exact, and incorporate a wide range of problem formulations. All these papers tackle aspects of the same problem, i.e. the close to real-time determination of operating set-points for all controllable devices available in a power system. Yet, a consensus regarding the associated formulation and time-scale of application has not been reached. Of course, given the large scale of the problem, decentralization is unavoidably part of the solution. In this work we explore the existing and developing trends in energy management and place them into perspective through a complete framework that allows optimizing energy usage at all levels in a power system

Demonstrating demand response from water distribution system through pump scheduling

Significant changes in the power generation mix are posing new challenges for the balancing systems of the grid. Many of these challenges are in the secondary electricity grid regulation services and could be met through demand response (DR) services. We explore the opportunities for a water distribution system (WDS) to provide balancing services with demand response through pump scheduling and evaluate the associated benefits. Using a benchmark network and demand response mechanisms available in the UK, these benefits are assessed in terms of reduced green house gas (GHG) emissions from the grid due to the displacement of more polluting power sources and additional revenues for water utilities. The optimal pump scheduling problem is formulated as a mixed-integer optimisation problem and solved using a branch and bound algorithm. This new formulation finds the optimal level of power capacity to commit to the provision of demand response for a range of reserve energy provision and frequency response schemes offered in the UK. For the first time we show that DR from WDS can offer financial benefits to WDS operators while providing response energy to the grid with less greenhouse gas emissions than competing reserve energy technologies. Using a Monte Carlo simulation based on data from 2014, we demonstrate that the cost of providing the storage energy is less than the financial compensation available for the equivalent energy supply. The GHG emissions from the demand response provision from a WDS are also shown to be smaller than those of contemporary competing technologies such as open cycle gas turbines. The demand response services considered vary in their response time and duration as well as commitment requirements. The financial viability of a demand response service committed continuously is shown to be strongly dependent on the utilisation of the pumps and the electricity tariffs used by water utilities. Through the analysis of range of water demand scenarios and financial incentives using real market data, we demonstrate how a WDS can participate in a demand response scheme and generate financial gains and environmental benefits

Virtual power plant models and electricity markets - A review

In recent years, the integration of distributed generation in power systems has been accompanied by new facility operations strategies. Thus, it has become increasingly important to enhance management capabilities regarding the aggregation of distributed electricity production and demand through different types of virtual power plants (VPPs). It is also important to exploit their ability to participate in electricity markets to maximize operating profits. This review article focuses on the classification and in-depth analysis of recent studies that propose VPP models including interactions with different types of energy markets. This classification is formulated according to the most important aspects to be considered for these VPPs. These include the formulation of the model, techniques for solving mathematical problems, participation in different types of markets, and the applicability of the proposed models to real case studies. From the analysis of the studies, it is concluded that the most recent models tend to be more complete and realistic in addition to featuring greater diversity in the types of electricity markets in which VPPs participate. The aim of this review is to identify the most profitable VPP scheme to be applied in each regulatory environment. It also highlights the challenges remaining in this field of study

Optimization of Sustainable Urban Energy Systems: Model Development and Application

Digital Appendix: Optimization of Sustainable Urban Energy Systems: Model Development and Applicatio