Ethics Pediatric Priority Statement

Under the guidance of the International Pediatric Transplant Association (IPTA) Executive Council, the IPTA Ethics Committee was asked to develop a position statement supporting prioritizing pediatric recipients for deceased donor organ allocation. This position statement has been published in the journal Pediatric Transplantation, the official journal of IPTA, on December 5, 2022.
The journal’s editorial staff and publishers have kindly designated the position statement as free content to allow it to be viewed on the journal website without subscription. We would encourage readers to review the position statement in total published

As part of this position statement, IPTA endorses the following policy recommendations:

  1. Within countries or regions that have standardized organ allocation policies, IPTA advocates in favor of prioritizing pediatric recipients for organ allocation. This prioritization should be implemented with acknowledgement of the needs of other stakeholders within the allocation system. IPTA has no singular position on what age threshold should define which potential recipients are considered pediatric patients. Different organs have different age considerations and thresholds. Age considerations should be determined in each jurisdiction and may differ based on the societal norms that differentiate children from adults as well as the technical considerations mandated by clinical constraints. However, the final allocation system should acknowledge the unique benefits experienced by pediatric recipients, the acute need to address pediatric organ failure in a timely manner due to the accrual of significant and sometimes permanent developmental morbidity, and the broader obligations that society has to provide for their health. Within countries or regions where allocation decisions are made by individual programs, we would urge those individuals responsible for organ allocation to consider these factors as well and incorporate those considerations into the allocation process.
  2. Whenever possible, IPTA supports the establishment of transparent, publicly accessible, and formalized allocation systems within local, regional, national and (if applicable) international health systems to minimize disparities in allocation practices that may adversely affect children.
  3. Where technical expertise exists, IPTA supports the use of technical innovations such as split liver transplantation, which will enhance availability of organs for allocation to both children and adults
  4. In order to ensure that these goals are achieved, IPTA recommends the engagement of individuals with expertise in pediatric transplantation in the process of developing and regularly updating local, regional, or national organ allocation policies whenever possible.

Michael A. Freeman, Jean Botha, Eileen Brewer, Mihaela Damian, Robert Ettenger, Katheryn Gambetta, Debra S. Lefkowitz, Lainie Friedman Ross, Riccardo Superina, Mignon I. McCulloch and Tom Blydt-Hansen on behalf the IPTA Ethics Committee

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