Impact of Change in the United Kingdom Pediatric Donor Organ Allocation Policy for Intestinal Transplantation

Giovanelli, M.; Gupte, Girish; McKiernan, Patrick; Pocock, Phil; Beath, S. V.; Lloyd, Carla; Sharif, Khalid; Mayer, David; Mirza, Darius F.

doi:10.1097/tp.0b013e3181a5e9f8

Cited by 21 publications

(15 citation statements)

References 14 publications

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“…In the post-1998 era, of the 230 children assessed for ITx 98 were recommended for transplant, 45 intestinal transplants were performed (7 IITx transplant and 14 size-matched CLITx, 23 CRLITx; 13 children also had reduction in donor intestinal length ), whereas 24 children died on the waiting list. Although the number of intestinal transplants increased during the timeperiod, the lack of availability of small sized donors in UK resulted in increased deaths on transplant waiting list in children under 10 kg [7].…”

Section: Impact Of Using Crlitx On Number Of Transplants and Death Onmentioning

confidence: 99%

Surgical complications after intestinal transplantation in infants and children—UK experience

Gupte

Haghighi

Sharif

et al. 2010

Journal of Pediatric Surgery

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Section: Impact Of Using Crlitx On Number Of Transplants and Death Onmentioning

confidence: 99%

Surgical complications after intestinal transplantation in infants and children—UK experience

Gupte

Haghighi

Sharif

et al. 2010

Journal of Pediatric Surgery

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“…As in adult medicine, the number of children who would benefit from organ transplantation far exceeds the number of donors 1 2. While seat belts, cycle helmets and improvements in paediatric intensive care have led to a decrease in the number of children dying from severe traumatic brain injury,3 there can be little doubt that opportunities for donation are missed.…”

Section: Introductionmentioning

confidence: 99%

Paediatric organ donation in the UK

Brierley

2009

Archives of Disease in Childhood

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“…2 Number of deaths per 1000 patient years waiting for a transplant. (17,18). We observed that the 23 extra points allotted to pediatric liver-intestine candidates in period 4 decreased their mortality substantially and narrowed the gap between liver-intestine and liver-only mortality (Figure 2).…”

Section: Discussionmentioning

confidence: 84%

The Impact of MELD/PELD Revisions on the Mortality of Liver–Intestine Transplantation Candidates

Kaplan

Han

Halgrimson

et al. 2011

American Journal of Transplantation

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Patients listed for liver-intestine transplantation suffer higher waiting list mortality than those listed for liver-only, thus leading to policy revisions seeking to close the gap. We sought to determine the impact of key model for end-stage liver disease (MELD)/pediatric end-stage liver disease (PELD) policy modifications on the waiting list mortality of adult and pediatric liverintestine candidates as compared to liver-only candidates. Analysis of UNOS data separated into adult and pediatric categories and based on time periods of policy implementation revealed higher mortality in liver-intestine candidates over all time periods studied (p < 0.001 pediatric and adult). After implementation of a revision to augment their MELD scores based on a sliding scale, adult liver-intestine candidates with calculated MELD > 15 no longer suffered higher mortality although this change did not completely eliminate the mortality disparity for candidates with MELD < 15 (p < 0.01). The waiting list mortality of pediatric liver-intestine candidates dropped significantly after a revision that gave them 23 additional MELD/PELD points (p < 0.01) although the mortality disparity with pediatric liver-only candidates was not eliminated. Following this revision, mortality in pediatric liver-only and liver-intestine Status 1 candidates was similar, however more liver-intestine candidates were listed as Status 1B. This data demonstrates that a mortality disparity remains for liver-intestine candidates compared with candidates listed for liver-only.

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Impact of Change in the United Kingdom Pediatric Donor Organ Allocation Policy for Intestinal Transplantation

Abstract: The new prioritization of the national pediatric donor allocation favoring IT has resulted in an increased number of procedures, without an impact on waiting list mortality for small children.

Cited by 21 publications

References 14 publications

Surgical complications after intestinal transplantation in infants and children—UK experience

Surgical complications after intestinal transplantation in infants and children—UK experience

Paediatric organ donation in the UK

The Impact of MELD/PELD Revisions on the Mortality of Liver–Intestine Transplantation Candidates

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