Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Feb:27 Suppl 1:e14253.
doi: 10.1111/petr.14253. Epub 2022 Dec 5.

Pediatric impacts of multiorgan transplant allocation policy in the United States

Rachel M Engen  1 , Sonya Kirmani  1
Affiliations
Review

Pediatric impacts of multiorgan transplant allocation policy in the United States

Rachel M Engen et al. Pediatr Transplant. 2023 Feb.

Abstract

Background: Multiorgan transplantation is increasingly common, driving recent increased attention to multiorgan allocation policies.

Methods: In this review, we summarize current multiorgan transplant allocation policies in the United States, with attention to recent and proposed changes and their impact on pediatric candidates.

Results: Existing multiorgan transplant policies attempt to balance equity and utility. Currently, there are clear allocation policies for some, but not all, multiorgan transplant combinations, and there are no mandatory outcomes reporting. Multiorgan candidates are prioritized above all kidney-alone transplant candidates, which negatively affect pediatric kidney transplant wait times. Pediatric candidates are typically exempt from multiorgan listing criteria.

Conclusion: Multiorgan transplant allocation presents unique challenges for policy development. As the United States Network for Organ Sharing begins exploring continuous distribution allocation, multiorgan allocation will require special consideration and the development of clear and equitable policies.

Keywords: allocation; multiorgan transplant; pediatric; policy.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

REFERENCES

    1. OPTN. National Data-OPTN. https://OPTN.transplant.hrsa.gov/data/view-data-reports/national-data/
    1. Electronic Code of Federal Regulations (eCFR). https://www.ecfr.gov/cgi-bin/text-idx?SID=bb60e0a7222f4086a88c31211cac77...
    1. Karamlou T, Welke KF, McMullan DM, et al. Combined heart-kidney transplant improves post-transplant survival compared with isolated heart transplant in recipients with reduced glomerular filtration rate: Analysis of 593 combined heart-kidney transplants from the United Network Organ Sharing Datab. J Thorac Cardiovasc Surg. 2014;147(1):456-461.e1
    1. Nagai S, Safwan M, Collins K, et al. Liver alone or simultaneous liver-kidney transplant? Pretransplant chronic kidney disease and post-transplant outcome - a retrospective study. Transpl Int. 2018;31:1028-1040.
    1. OPTN Pediatric Transplantation Committee. Examining Kidney Priority for Multi-Organ Candidates Compared to Pediatric Kidney-Alone Candidates. (2020).