Let me tell you, folks, when it comes to saving the lives of children with end-stage liver disease, liver transplantation is the only game in town. It’s huge, it’s important. But, let’s be honest, the field is a bit all over the place – we’re talking different graft types, ages, weights, diseases. It’s complicated!

Now, we’ve seen some big improvements lately, more living donors stepping up – fantastic people, the best. But here’s the deal: too many kids, especially the little ones, are still dying while waiting for a transplant. Unacceptable!

And why? Because the number of suitable donors is limited. We’re talking about issues with donor age, body mass index, and how long those organs are on ice. It’s a real problem.

But, there’s hope. Machine perfusion – this technology is making a comeback, especially for adults. We’ve got ten studies showing it’s better than the old cold storage method. Better survival, better outcomes. And for kids? The hypothermic oxygenated perfusion (HOPE) is leading the charge. It’s the first, it’s the only, and it’s showing promise.

In 2018, a breakthrough: a child received a full-size liver with HOPE. And then, some split liver transplants. The numbers? Still small, but the results? Impressive. Our friends in France? They’re doing amazing work with split procedures, seeing fewer complications, better survival. It’s fantastic.

This is just the beginning. We’re on the brink of something big here, using machine perfusion for all kinds of grafts in kids. We’re waiting on more reports, more success stories. And let me tell you, it’s going to take a team effort to make this happen. We’re talking about not just saving lives now, but setting these kids up for a lifetime of success. It’s huge, folks. Truly huge.