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

Youngrok Choi; Kwang-Woong Lee; Geun Hong; Hyeyoung Kim; Min-Su Park; Sukwon Suh; Tae Yoo; Hae Won Lee; Nam-Joon Yi; Kyung-Suk Suh

doi:10.4285/jkstn.2012.26.3.196

Journal List > J Korean Soc Transplant > v.26(3) > 1034375

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Choi, Lee, Hong, Kim, Park, Suh, Yoo, Lee, Yi, and Suh: Status and Current Problems in the Allocation System for Pediatric Liver Transplantation in Korea

Original Article

The Journal of the Korean Society for Transplantation

The Journal of the Korean Society for Transplantation 2012; 26(3): 196-201.

Published online: 28 September 2012

DOI: https://doi.org/10.4285/jkstn.2012.26.3.196

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

Youngrok Choi, M.D., Kwang-Woong Lee, M.D., Geun Hong, M.D., Hyeyoung Kim, M.D., Min-Su Park, M.D., Sukwon Suh, M.D., Tae Yoo, M.D., Hae Won Lee, M.D., Nam-Joon Yi, M.D., Kyung-Suk Suh, M.D.

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author (kwleegs@gmail.com)

Received 4 May 2012 Accepted 18 June 2012

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.

Keywords: Split, Allocation, Pediatric liver transplantation

Figures and Tables

Fig. 1

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

Fig. 2

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

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.

Table 1

The number of liver transplantation (LT) and pediatric LT from 2006 to 2010

Table 2

Distribution of adult and pediatric deceased donors according to recipients age (January 2006~March 2012)

Table 3

The reasons for refusing the proposal of SLT (240 candidates)

Abbreviations: SLT, split liver transplantation; LT, liver transplantation.

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