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Quality initiatives in pediatric transplantation

Kelly, Beaua; Squires, James E.b; Feingold, Brianc; Hooper, David K.d; Mazariegos, George V.e

Current Opinion in Organ Transplantation: February 2019 - Volume 24 - Issue 1 - p 64–72
doi: 10.1097/MOT.0000000000000595

Purpose of review Pediatric transplantation faces unique challenges in implementing dynamic quality improvement measures because of proportionally smaller volumes compared to adults, logistics of being integrated successfully within larger or complex hospital systems, lack of adult-affiliated transplant centers, varying focus in prioritization of relevant outcome metrics, and potential lack of sufficient resources.

Recent findings To address these challenges, multiinstitutional collaborations have developed which have proven increasingly effective in driving awareness and quality improvement measures to supplement regulatory efforts in the pediatric population. Relevant work from the Pediatric Heart Transplant Society and Studies in Pediatric Liver Transplantation will be highlighted. The introduction of learning networks such as the Improving Renal Outcomes Collaborative and the Starzl Network for Excellence in Pediatric Transplantation have further focused on continuous learning initiatives in renal and liver transplantation using collaboration and patient informed measures.

Summary Optimal transplant performance improvement is fully integrated into health delivery at all points of the patient pathway. Progress in performance improvement will require ongoing integration of big data solutions, improved patient engagement and technology solutions.

Video Abstract:

aDCI Donor Services, Sacramento, California

bDivision of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh

cPediatrics and Clinical and Translational Research, University of Pittsburgh, Pittsburgh, Pennsylvania

dDivision of Nephrology and Hypertension, James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio

eDepartment of Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA

Correspondence to George V. Mazariegos, MD, Department of Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, FP 6th Floor, 6141, Pittsburgh, PA 15224, USA. Tel: +1 412 692 7867; e-mail:

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