JAMA Pediatrics: Transplantation Topic Collection

Pediatric Organ Transplantation Needs Organ Donation Best Practices

Bratton SL, Kolovos NS, Roach ES, et al. — Mon, 01 May 2006 00:00:00 GMT

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. Another 40 children per year will be removed from the list when their medical conditions deteriorate so badly that transplantation is no longer possible. 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).

Meeting the Need for Transplantable Organs Through the US Donation System

Lorber MI. — Mon, 01 May 2006 00:00:00 GMT

Bratton et al report some of the recent approaches being used to improve donor organ availability. Although their focus was pediatric patients, they point out that the problem has risen to crisis proportions for children and adults alike. Certainly, the donor shortage has become one of the most pressing problems facing the field of transplantation on many levels. Improved results have established transplantation as the preferred treatment for many forms of organ failure, leading to the tremendous growth in transplant waiting lists. This growth contrasts dramatically with only modest increases in the number of available transplantable organs. This frustrating reality challenges patients, their families, and caregivers alike as the promise of transplantation cannot be delivered with increasing frequency. Instead of transplantation, candidates must endure long waiting times, often leading to medical deterioration and sometimes death, never having had the opportunity to receive a needed organ.