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Most livers donated by children go to adults
Posted
5-31-99 Pittsburgh. Almost two-thirds of pediatric livers are going to adult liver transplant recipients, according to a study by Rakesh Sindhi, MD, research assistant professor of surgery at the University of Pittsburgh's Thomas E. Starzl Transplantation Institute and Children's Hospital of Pittsburgh. Sindhi reviewed nearly 30,000 liver transplants done in the United States since 1991. There's an easy explanation for why more adults than children are receiving children's livers-it's simply that there are many more adults awaiting liver transplants than children, Sindhi said. "The number of children waiting is stable at around 500 each year, while the number of adults is increasing exponentially," he said. Recipients, regardless of age, are chosen according to a waiting-list databank maintained by the United Network for Organ Sharing. "One possible solution," Sindhi said, "is to conduct a detailed analysis to identify children who may benefit most from the use of grafts from children. These might include children who are in ICUs." Another option would be to increase the number of "split-livers" that are available, he said. With this technique, one liver can be separated into two grafts, with the larger segment going to an adult and the smaller piece to a child. "If we can increase the number of split-liver grafts," Sindhi said, "it has the potential to take care of a significant number of children and adults needing livers." This is exactly what is already happening, said Janet Mize, RN, president-elect of the International Transplant Nurses Society and transplant administrator and senior coordinator at the University of California Irvine Medical Center. "Techniques are evolving to improve the success rate of split livers," she said, "and this is going to be the way that children waiting will be able to get livers."
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