Commentary |

Pediatric Organ Transplantation Needs:  Organ Donation Best Practices

Susan L. Bratton, MD, MPH; Nikoleta S. Kolovos, MD; Elizabeth S. Roach, RN, BSN; Virginia McBride, MPH, RN; Judy L. Geiger, RN, BSN; Rebecka L. Meyers, MD
Arch Pediatr Adolesc Med. 2006;160(5):468-472. doi:10.1001/archpedi.160.5.468.
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According to the national Organ Procurement and Transplantation Network, of the more than 87 000 people currently awaiting organ transplantation in the United States, more than 6000 will die annually before receiving an organ. Two hundred sixty of those who will die are children.1,2 Another 40 children per year will be removed from the list when their medical conditions deteriorate so badly that transplantation is no longer possible.1 The number of adult and child candidates for transplantation has risen over the past decade with adult candidate numbers increasing by 19% annually. Over the same time, pediatric candidates also increased in number but less dramatically (16% over the decade) (Figure 1). However, increased numbers of adult candidates compete for organs previously available to children. Among children, the greatest increased organ needs are for small bowel (increased from 70 in 1995 to 155 in 2004) and kidney transplants (increased from 585 in 1995 to 875 in 2004).

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Figure 1.

Patients younger than 18 years listed for organ transplantation during 1995 through 2004. The greatest increases are for kidney and small-bowel transplantations.

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Figure 2.

Pediatric kidney and liver transplant recipients from living and deceased donors, 1995 through 2004.

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Figure 3.

Pediatric donors (<18 years of age) during 1995 through 2004.

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Figure 4.

Trends in donors after cardiac death during 1995 through 2004.

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