J Korean Soc Transplant.  2012 Sep;26(3):196-201. 10.4285/jkstn.2012.26.3.196.

Status and Current Problems in the Allocation System for Pediatric Liver Transplantation in Korea

• Choi Y
• Lee KW
• Hong G
• Kim H
• Park MS
• Suh S
• Yoo T
• Lee HW
• Yi NJ
• Suh KS

• KMID: 2003535
• DOI: http://doi.org/10.4285/jkstn.2012.26.3.196

Abstract

BACKGROUND
The aim of this study was to investigate the current status and identify any existing problems in the allocation system of liver transplantation (LT) for children in Korea.
METHODS
The information for the period between January 2006 and March 2012 contained in the Korean Network for Organ Sharing (KONOS) database, and the 2008 and 2010 annual reports from KONOS were analyzed. Detailed information about split LT (SLT) was analyzed using the SLT database which contains data collected since 2010.
RESULTS
Of 4,462 cases of LT between January 2006 and December 2010, 243 were pediatric cases (5.4%). Of these pediatric cases, 195 (80.2%) were living donor LT. Of the liver grafts from deceased pediatric donors, 68% were donated to adults and 3.9% were shared with children. Of the 104 splittable donors from January 2010 to March 2012, a split was performed only in 4.6% of cases. The main reason for the low split rate was few pediatric candidate(s) in the waiting list due to strict Korean regulatory requirements for split candidate registration.
CONCLUSIONS
Under the current liver transplant allocation system, Korean children have less chance to receive a liver graft from a deceased donor. With improvement of the allocation system and the rules governing SLT, children in need may have greater opportunity to receive a deceased donor graft without negatively affecting adult recipients.

Keyword

Split; Allocation; Pediatric liver transplantation

MeSH Terms

Adult
Child
Humans
Korea
Liver
Liver Transplantation
Living Donors
Tissue Donors
Transplants
Waiting Lists

Figure

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  Fig. 1 Distribution of deceased donors by age (January 2006~March 2012). Values are expressed as number (%).

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  Fig. 2 The number of child and adult liver transplantation (LT) according to deceased donor age (January 2006~March 2012).

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  Fig. 3 Current allocation status of splittable donors in Korea. Among 104 splittable donors who met split donor criteria, adequate pediatric candidates were found and matched only in 29 patients (28%). However, the real split was performed only in half. Abbreviation: SLT, split liver transplantation.

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