Trends over a decade of pediatric liver transplantation in the United States.
During the last 10 to 15 years, medical and surgical innovations have established pediatric liver transplantation as the optimal therapy for children suffering acute and chronic liver disease. We hypothesized that the profile of current pediatric liver transplant recipients would differ significantly from that of an earlier era. We collected and compared data regarding the characteristics of children undergoing liver transplantation alone in 2 eras separated by more than a decade from the Organ Procurement and Transplantation Network/United Network for Organ Sharing database. Transplant recipients from March 1, 2002 to December 31, 2004, compared to those from January 1, 1990, to December 31, 1992, tended to be more evenly distributed across age, race/ethnicity, and disease etiology. There was a major shift toward utilization of partial grafts from both deceased and living donors to achieve transplantation for the youngest children (<1 and 1-5 yr) in particular. However, in spite of these innovative transplant strategies and only a modest increase in demand for pediatric liver transplantation, wait list times for both pediatric candidates and recipients have still increased between eras. In conclusion, the sobering reality that mortality on the waiting list remains highest for the youngest pediatric liver candidates frames our challenge for the next decade.
Feng
Sandy
S
Department of Surgery, University of California San Francisco, San Francisco, CA 94143-0780, USA. fengs@surgery.ucsf.edu
Si
Ming
M
Taranto
Sarah E
SE
McBride
Maureen A
MA
Mudge
Christine
C
Stritzel
Susan
S
Roberts
John P
JP
Rosenthal
Philip
P
D000293:Adolescent; D001787:Blood Group Incompatibility; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity; D005260:Female; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D016031:Liver Transplantation / Q000276:immunology / Q000706:statistics & numerical data / Q000639:trends*; D019520:Living Donors; D008297:Male; D012189:Retrospective Studies; D014481:United States; D014850:Waiting Lists