Children Deserve an Equal Chance at Receiving a Life-Saving Livers

On May 14, 2019, the new OPTN liver allocation policy went into effect. In the 72 hours in which the policy was in place, there were numerous stories of children receiving livers after being on the waitlist for months. The policy was working as intended – greater sharing of livers was being achieved. Unfortunately, due to a lawsuit that was filed a mere 24 hours after the policy was implemented, the greater sharing was halted.

Liver allocation has now reverted to a system in which adult liver transplants are prioritized over pediatric ones and geographic regions plays a major factor in how long a patient will remain on the waitlist. Today’s system puts children at a disadvantage where pediatric livers are first offered to adults locally, rather than sicker children further away. 600 pediatric patients received livers in 2015, compared to 6,500 for adults. In a five-year time period, 316 children died on the waitlist, while 1,500 adults were transplanted with livers from children.

The new OPTN policy needs to implemented as intended to ensure that children are not dying while adults are transplanted at almost ten times the rate. The new policy would ensure greater sharing for children while not adversely affecting adults. An estimated 114 lives would be saved in the next year if the policy was in place and prioritizing pediatric patients increases the chances of splitting a liver and benefiting two lives.

While this issue is still pending resolution in court, it is important for the public to understand the consequences of these delays and to urge implementation of the new reforms as quickly as is feasible.  We have signed an open letter and petition to reinstitute the 2018 policy and we encourage others to do the same. Children deserve an equal chance at receiving a life-saving liver.

Billy Wynne