Implementation of a Novel Multi‐Center Pediatric Liver Transplant Collaborative Network

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Abstract
Background: Initiation or augmentation of pediatric liver transplant programs in the United States faces challenges of limited expertise, small volumes, and regional variation in access to care. PACH launched a prospective plan of pediatric liver program development at two sites (VAUV and FLFH) with the goals of comprehensive multidisciplinary program support, consistent surgical leadership from one team, consensus protocol development, and standardization of perioperative and postoperative care, and comprehensive long‐term follow‐up care plans. A third center, NCCM, was launched in June 2024. Methods: Between January 2016 and December 31, 2024, 140 children received pediatric liver transplants at one of the collaborative sites. A total of 215 PLT were performed at PACH during the same period. Results: Patient and graft survival were 94.4% and 93.2% respectively, with current follow‐up of 1674 ± 1037 days. Overall patient demographics, complications, and patient outcomes were similar among all institutions. Conclusions: A paradigm of systematically extending center experience directly to facilitate safe and high‐quality pediatric liver program establishment has been demonstrated, with the additional benefit of increased split liver graft utilization benefiting both adults and children. The success of this model has implications for optimizing pediatric liver transplant care in the United States.

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