ArticleTransplantation2019
Split Liver Transplantation and Pediatric Waitlist Mortality in the United States: Potential for Improvement.
Article in Transplantation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 103 citations in OpenAlex.
- First Split Liver Transplantation Using VitaSmart Hypothermic Machine Perfusion in the United States.Pediatric transplantation · 2026Article
- A 10-year analysis of the united network for organ sharing registry: Insights from machine learning to prevent pediatric waitlist deaths.Journal of pediatric gastroenterology and nutrition · 2026Article
- Donor size and early vascular complications in children receiving a whole liver transplant.World journal of transplantation · 2026Article
- Toward Next-Gen Cell Therapy for Pediatric Patients: Neonatal Hepatocytes Tolerate Electroporation-Mediated Gene Editing and Engraft in the Liver.The CRISPR journal · 2026Article
- A nomogram for predicting postoperative intra-abdominal hypertension in pediatric patients following liver transplantation: a prospective observational study.BMC pediatrics · 2025Observational
- Utilization of a Pediatric DCD Liver Following Normothermic Regional Perfusion: A Case Report on the Youngest Donor in the United States.Pediatric transplantation · 2025Article
- Optimizing liver utilization for transplantation with partial grafts undergoing normothermic machine perfusion: Two case reports.World journal of transplantation · 2025Article
- Ultrasound of the rectus femoris as a novel tool to measure sarcopenia in pediatric chronic liver disease.Hepatology communications · 2025Article
- Article
- Pediatric-adult split liver transplantation: an ethical imperative and systems-based roadmap for global expansion.Frontiers in transplantation · 2025Article
- Effects of Adding Congested Segment IV to the Left Lateral Graft on Short-term Outcomes in Pediatric Living-donor Liver-transplant Recipients.Transplantation direct · 2023Article
- Can non-directed living liver donation help improve access to grafts and correct socioeconomic disparities in pediatric liver transplantation?Pediatric transplantation · 2023Article
- An appraisal of technical variant grafts compared to whole liver grafts in pediatric liver transplant recipients: Multicenter analysis from the SPLIT registry.Pediatric transplantation · 2023Article
- Accumulation of Postoperative Unexpected Events Assessed by the Comprehensive Complication IndexChildren (Basel, Switzerland) · 2022Article
- Ethics of split liver transplantation: should a large liver always be split if medically safe?Journal of medical ethics · 2022Article
- IV segment portal vein reconstruction in split-liver transplantation with extended right grafts.BMC surgery · 2022Article
- Organ allocation in pediatric abdominal transplant.Seminars in pediatric surgery · 2022Article
- Variability of Care and Access to Transplantation for Children with Biliary Atresia Who Need a Liver Replacement.Journal of clinical medicine · 2022Article
- Living Donor Liver Transplantation vs. Split Liver Transplantation Using Left Lateral Segment Grafts in Pediatric Recipients: An Analysis of the UNOS Database.Transplant international : official journal of the European Society for Organ Transplantation · 2022Article
- Living Donor Versus Deceased Donor Pediatric Liver Transplantation: A Systematic Review and Meta-analysis.Transplantation direct · 2021Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIn the United States, 1 in 10 infants and 1 in 20 older children die on the liver transplant waiting list. Increasing split liver transplantation could increase organ availability for these children, without decreasing transplants in adults.
methodsUsing United Network for Organ Sharing Standard Transplant Analysis and Research data, we identified livers transplanted 2010 to 2015 that could potentially have been used for split transplant, based on strict criteria. Livers not suitable for pediatric patients or allocated to high-risk recipients were excluded. Number and distribution of potentially "split-able" livers were compared to pediatric waitlist deaths in each region.
resultsOf 37 333 deceased donor livers transplanted, 6.3% met our strict criteria for utilization in split liver transplant. Only 3.8% of these were actually utilized for split liver transplantation. 96% were used for a single adult recipient. Of the 2253 transplanted as whole livers, 82% of their recipients were listed as willing to accept a segmental liver, and only 3% were listed as requiring a cold ischemia time less than 6 hours. Over the same 5 years, 299 children died on the waitlist. In every United Network for Organ Sharing region, there were more potentially "split-able" livers than pediatric waitlist deaths. Thirty-seven percent of pediatric waitlist deaths occurred at transplant centers that averaged 1 or less pediatric split liver transplantation annually during the study period.
conclusionsThis comparison, although not conclusive, suggests that we might be missing opportunities to reduce pediatric waitlist mortality without decreasing access for adults-using split liver transplant. Barriers are significant, but further work on strategies to increase split liver transplant is warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.