Similarities and Differences in Allocation Policies for Pediatric Liver Transplantation Across the World

Objectives: We aimed to investigate national allocation policies for pediatric liver transplantation. Method: A survey was prepared by the ESPGHAN hepatology committee in collaboration with the North-American SPLIT (Studies of Pediatric Liver Transplantation) consortium. The survey was sent to pediatric hepatologists and transplant surgeons worldwide. National data were obtained from centrally based registries. Results: Replies were obtained from 15 countries from five of the world continents. Overall donation rate varied between 9 and 35 per million inhabitants. The number of pediatric liver transplantations was 4–9 per million inhabitants below 18 years of age for 13 of the 15 respondents. In children below 2 years of age mortality on the waiting list varied between 0 and 20%. In the same age group, there were large differences in the ratio of living donor liver transplantation to deceased donor liver transplantation as well as in the ratio of split liver segments to whole liver. These differences were associated with possible discrepancies in waiting list mortality. Conclusion: Similarities but also differences between countries were detected. The described data may be of importance when trying to reduce waiting list mortality in the youngest children. Address correspondence and reprint requests to Björn Fischler, Dept. of Pediatrics Karolinska University Hospital, CLINTEC Karolinska Institutet, SE-14186 Stockholm, Sweden (e-mail: bjorn.fischler@sll.se). Received 4 May, 2018 Accepted 22 December, 2018 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). No conflicts of interest. © 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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