Expansion of the Pediatric Donor Pool for Liver Transplantation in the United States

Abstract

As the greatest survival benefit owing to Orthotopic Liver Transplantation (OLT) is achieved in the pediatric population (< 18 years of age), the United States (US) annual unmet need of more than 100 pediatric liver allografts warrants an innovative approach to reduce this organ deficiency. We present a three-pronged strategy with the potential to eliminate the disparity between supply and demand of pediatric liver allografts: (1) optimize the current supply of donor livers, (2) further capitalize on technical variant allografts from cadaveric and living donation, and (3) implement a novel donation approach, termed 'Imminent Death Donation' (IDD), allowing for donation of the left lateral segment prior to life support withdrawal in patients not meeting brain death criterion.