Using More Split Livers Could Save Hundreds More Children And Adults
CHICAGO, May 17 -- Nearly two-thirds of all livers donated by children since 1991 were transplanted into adults instead of their peers on the national liver transplant waiting list, despite an increase in the number of pediatric donors, an analysis of nearly 30,000 liver transplants performed in the United States shows.
With fewer of these livers available for children, surgeons have been forced to look at alternative options, such as those involving transplanting a piece of a liver. These types of procedures have increased dramatically, with adults -- as either living or cadaveric donors -- the primary source of these liver segments. But such efforts have had an impact neither on the waiting list death rate nor on the total number of transplants in children each year, reported University of Pittsburgh researchers today at the American Society of Transplantation (AST) 18th Annual Scientific Meeting.
"How can we assure that children are better served? One might propose a preferential allocation system that matches pediatric organs to the highest-risk children. Another option is the greater exploitation and broader sharing of split liver grafts. Such measures could enhance the survival of these children to levels similar to the entire transplant population," said Rakesh Sindhi, M.D., research assistant professor of surgery at the University of Pittsburgh's Thomas E. Starzl Transplantation Institute and Children's Hospital of Pittsburgh.
"Split livers, on the other hand, could essentially double the number of organs available for transplant for both children and adults," he added.
The review of the United Network for Organ Sharing (UNOS) Scientific Registry
data of transplants performed between 1991 and 1998 showed that 4,288 of 6,028
pediatric livers were used in adults. While the number of adults who received
livers from child donors increased each yea
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Contact: Lisa Rossi
rossiL@msx.upmc.edu
412-624-2607
University of Pittsburgh Medical Center
17-May-1999