Increased risk organ transplantation in the pediatric population
Sean M. Wrenn
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Search for more papers by this authorPeter W. Callas
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Search for more papers by this authorTrishul Kapoor
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Department of General Surgery, Mayo Clinic Rochester, Rochester, MN, USA
Search for more papers by this authorAlia F. Aunchman
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Search for more papers by this authorAdam N. Paine
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Search for more papers by this authorJaime A. Pineda
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Search for more papers by this authorCorresponding Author
Carlos E. Marroquin
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Correspondence
Carlos E. Marroquin, Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA.
Email: [email protected]
Search for more papers by this authorSean M. Wrenn
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Search for more papers by this authorPeter W. Callas
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Search for more papers by this authorTrishul Kapoor
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Department of General Surgery, Mayo Clinic Rochester, Rochester, MN, USA
Search for more papers by this authorAlia F. Aunchman
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Search for more papers by this authorAdam N. Paine
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Search for more papers by this authorJaime A. Pineda
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Search for more papers by this authorCorresponding Author
Carlos E. Marroquin
Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, VT, USA
Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA
Correspondence
Carlos E. Marroquin, Division of Transplant Surgery, University of Vermont Medical Center, Burlington, VT, USA.
Email: [email protected]
Search for more papers by this authorAbstract
IRD organs are classified by the Public Health Service to be at above-average risk for harboring human immunodeficiency virus, hepatitis C, and hepatitis B. Traditionally underutilized, there exists even greater reluctance for their use in pediatric patients. We performed a retrospective analysis via the United Network for Organ Sharing database of all pediatric renal and hepatic transplants performed from 2004 to 2008 in the United States. Primary outcomes were patient and graft survival. Proportional hazards regression was performed to control for potentially confounding factors. Waitlist time, organ acceptance rates, and infectious transmissions were analyzed. There were 1830 SRD renal, 92 IRD renal, 1695 SRD hepatic, and 59 IRD hepatic transplants. There were no statistically significant differences in allograft or patient survival in either group. Acceptance rates of IRD organs were lower for kidney (1.5% IRD vs 4.82% SRD) and liver (1.99% IRD vs 4.51% SRD). One transmission of a bloodborne pathogen involving a pediatric recipient out of 7797 unique transplants was reported from 2008 to 2015. IRD organs appear to have equivalent outcomes. Increasing their utilization may improve access to transplant while decreasing wait times and circumventing waitlist morbidity and mortality.
Supporting Information
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