Infants and young children have the highest risk of death on the liver transplant waiting list, mainly due to the shortage of appropriately sized organs. To combat this, Heung Bae Kim, MD, director of Boston Children’s Pediatric Transplant Center, has been researching ways to change that statistic.
In 2014, Dr. Kim and his team of researchers at Boston Children’s published their findings in Liver Transplantation, where data suggests that both split and whole organs had similarly low rates of both graft failure and mortality for liver transplant patients under the age of 2. These findings suggest that their use could be increased to meet the demand for smaller grafts.
In a separate study, data on graft survival and mortality for adult split liver (R lobe) recipients (after children got the smaller left part) was compiled. The research showed that with the exception of a small, very sick population of adult patients, adults who receive a split graft can expect to fare as well as those who received a whole organ.
Based on his findings, Dr. Kim has been consistently advocating for changes in how donor livers are allocated — automatically placing infants and small children at the top of the liver waitlist. With this, pediatric transplant surgeons are given the option to split the first graft to become available. Once the liver has been split, the smaller portion is transplanted into a child and the larger portion is transplanted into the next appropriate adult on the list.
