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. 2022 Jun;31(3):151180.
doi: 10.1016/j.sempedsurg.2022.151180. Epub 2022 May 16.

Organ allocation in pediatric abdominal transplant

Leah Ott  1 , Khashayar Vakili  1 , Alex G Cuenca  2
Affiliations

Organ allocation in pediatric abdominal transplant

Leah Ott et al. Semin Pediatr Surg. 2022 Jun.

Abstract

Pediatric patients constitute an important group within the general transplant population, given the opportunity to significantly extend their lives with successful transplantation. Children have historically received special consideration under the various abdominal solid organ allocation algorithms, but matching patients with size and weight restrictions with appropriate donors remains an ongoing issue. Here, we describe the historical trends in pediatric organ allocation policies for liver, kidney, intestine, and pancreas transplantation. We also review recent changes to these allocation policies, with particular attention to recent amendments to geographical prioritization, with the dissolution of donor service areas and United Network for Organ Sharing (UNOS) regions and the subsequent creation of acuity circles.

Keywords: Acuity circles; Allocation; Pediatric transplant; UNOS; Utilization; Wait list.

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Figures

Fig. 1.
Fig. 1.
Acuity circles of 150 nm, 250 nm, and 500 nm around the donor hospital to prioritize allocation (adapted from UNOS Liver Policy: Distribution Example video).
Fig. 2.
Fig. 2.
Median deceased donor liver-alone recipient allocation MELD or PELD score transplant by donor service are of transplant center and era.
See this image and copyright information in PMC

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