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Global lessons in graft type and pediatric liver allocation: A path toward improving outcomes and eliminating

Evelyn K Hsu1, George V Mazariegos2

  • 1University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA.

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
|October 6, 2016
PubMed

Insights

This review examines pediatric liver allocation and organ procurement policies, advocating for an equitable system to improve outcomes for children awaiting transplants without negatively impacting adult recipients. International examples offer strategies for global consideration.

Area of Science:

  • Hepatology
  • Transplantation Medicine
  • Public Health Policy

Background:

  • Pediatric liver allocation and organ procurement policies require critical review.
  • Current systems face challenges in equitable distribution and patient outcomes.
  • Historical context and ethical frameworks underpin allocation decisions.

Purpose of the Study:

  • To review current literature and policy on pediatric liver allocation and organ procurement.
  • To propose a logical framework for an equitable pediatric liver allocation system.
  • To compare international policies with current US policy for potential strategies.

Main Methods:

  • Narrative review of current literature and policy.
  • Analysis of historical context, ethical frameworks, and technical considerations.
  • Comparative analysis of international and US pediatric liver allocation and split-liver policies.

Main Results:

  • Current pediatric liver allocation policies have historical and ethical considerations.
  • Technical and procurement factors influence allocation effectiveness.
  • International policies offer diverse strategies for pediatric liver allocation.

Conclusions:

  • An equitable pediatric liver allocation system is crucial for improving wait-list and posttransplant outcomes.
  • International best practices can inform improvements to US policy.
  • A globally considered approach can enhance pediatric liver transplantation.

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