Kids Waiting For Liver Transplants Are At A Disadvantage When In The Same Pool As Adults

Sep 18, 2018

Children waiting for a liver transplant are at a disadvantage when they're in competition with adults, according to a new study led by the University of Pittsburgh.

Right now, children under 12 years old waiting for a liver transplant receive a score that determines the severity of their illness. That calculation is based on factors including age and how well their liver functions. The higher the score, the more urgent their need for a transplant.

Adults receive a score based on slightly different factors, including if they've received dialysis in the week prior to scoring. Pitt Public Health Professor Mark Roberts said hypothetically, a child and an adult with the same score should have the same risk of death when waiting for a liver.

"But in our analysis what we found is ... the child actually has a much higher risk of death," Roberts said. "Therefore [they] should have a higher priority than the score implies."

Researchers analyzed the records of 2,421 children under 18 years old with chronic liver disease. They were all waiting for organ donations on the United Network for Organ Sharing list for livers. The study revealed that, when compared with adults, children were likely to die more quickly than their score predicted.

Roberts said this problem is so widely known in the medical community that doctors will sometimes grant their pediatric patients "exception points" so their priority is higher.

Roberts said the two different scoring systems were based on a small set of data from studies done over a decade ago. He said the findings highlight the need to create new scoring systems that better predict the likelihood of a patient dying without a new liver.

"These things need to be updated and rehashed and made sure that not only does this score rank children appropriately and the adult score rank adults appropriately, but rank them appropriately when comparing the two," Roberts said.
 

WESA receives funding from the University of Pittsburgh.