pISSN 2671-8790 eISSN 2671-8804

View

Article View

Korean J Transplant 2020; 34(3): 178-184

Published online September 30, 2020

https://doi.org/10.4285/kjt.2020.34.3.178

© The Korean Society for Transplantation

Korea-nationwide incidence of pediatric deceased donors and single-institutional status of liver transplantation using pediatric donor liver grafts

Jung-Man Namgung1 , Shin Hwang1 , Chul-Soo Ahn1 , Ki-Hun Kim1 , Deok-Bog Moon1 , Tae-Yong Ha1 , Gi-Won Song1 , Dong-Hwan Jung1 , Gil-Chun Park1 , Dea-Yeon Kim1 , Kyung Mo Kim2 , Seak Hee Oh2 , Sung-Gyu Lee1

1Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence to: Shin Hwang
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Tel: +82-2-3010-3930
Fax: +82-2-3010-6701
E-mail: shwang@amc.seoul.kr

Received: July 16, 2020; Revised: August 17, 2020; Accepted: August 17, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The present study intended to investigate the allocation status of pediatric deceased donor liver allografts. We analyzed the incidence of pediatric deceased donors in the Korean Network for Organ Sharing (KONOS) database and single-institutional status of liver transplantation (LT) using pediatric donors.
Methods: We assessed the nationwide incidence of pediatric donors aged ≤15 years and conducted single-center analysis of LT using pediatric donors.
Results: Between 2010 and 2019, pediatric donors aged ≤15 years accounted for 171 out of 4,395 donors (3.9%) in the KONOS database and 31 out of 640 liver donors (4.8%) in Asan Medical Center (AMC) database. In AMC, 11 (35.5%) and 20 (64.5%) grafts were allocated to pediatric recipients aged ≤15 years and adult recipients aged ≥19 years, respectively. All nine livers from donors aged ≤5 years were implanted in pediatric recipients aged ≤5 years. From 21 donors aged ≥9 years, 16 whole liver grafts and four split extended right liver grafts were implanted in 20 adult recipients and two split left lateral section grafts were implanted in two pediatric recipients. Four split liver grafts were implanted in other institutions. The overall patient survival rates at 1, 3, and 5 years were 90.9%, 80.8%, and 80.8%, respectively in pediatric-to-pediatric LT group and 69.6%, 58.4%, and 58.4%, respectively in pediatric-to-adult LT group (P=0.21).
Conclusions: More than half of the pediatric donor livers were allocated to adult patients. Recipient criteria for allocation of liver allografts from pediatric donors need revision for children on pediatric LT waitlist.

Keywords: Donor age, Pediatric donor, Deceased donor liver transplantation, Infant, Split liver transplantation

HIGHLIGHTS
  • We analyzed the incidence of pediatric deceased donors in Korean Network for Organ Sharing (KONOS) database and the single-institutional status of liver transplantation using pediatric donors.

  • The study results showed that over half of the pediatric donor livers were allocated to adult patients.

  • The recipient criteria for allocation of livers from pediatric donors should be revised to facilitate the special needs of children on the pediatric liver transplantation waitlist.