title: Obtaining consensus regarding international transplantation continues to be difficult for pediatric centers in the United States.
abstract: Organ transplant is life-saving and any given organ may be valuable to a multitude of potential recipients. An allocation system must be used to reconcile the difference between supply and demand, and this system must take into account the impact that accepting international patients may have on the local system. The principles for allocation must be clear, equitable, provide utility and must be monitored so as to maintain public trust. The impact of the system on metrics deemed to be critical must be measured. Finally, strategies must take into account the local culture, size of the region to be supported, the number and experience of transplant centers, and the resources of the healthcare delivery system. Our focus is on the United States, recognizing that strategies and challenges may vary across countries.
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Integrated Solid Organ Transplant Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Lorts
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Ryan
authors.affiliation: Ethics Center, Cincinnati Children's Medical Center, Cincinnati, OH, USA.
authors.forename: Armand H
authors.initials: AH
authors.lastname: Matheny Antommaria
authors.affiliation: Integrated Solid Organ Transplant Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lake
authors.affiliation: Integrated Solid Organ Transplant Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: John
authors.initials: J
authors.lastname: Bucuvalas
mesh_terms: D002648:Child; D032921:Consensus; D003906:Developing Countries; D015276:Health Care Rationing / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007391:International Cooperation; D016377:Organ Transplantation; D010372:Pediatrics; D012017:Referral and Consultation / Q000458:organization & administration; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D014481:United States