Pediatric Training and Experience Requirements—Development of UNOS Bylaws

Abstract

We review the background and process of policy development, which led to the development of the UNOS Pediatric Training and Experience Bylaws. Pre- and posttransplant outcomes mirror findings observed in the management of a variety of pediatric surgical diseases ranging from acute appendicitis to complex congenital heart disease. Specifically, patients treated at higher volume and typically pediatric focused institutions exhibit improved outcomes in terms of diagnosis, waitlist survival, and postoperative morbidity and mortality. Pediatric transplantation is a defined subspecialty within transplantation and requires additional pediatric training, experience, and resources to achieve optimal short- and long-term outcomes in this unique patient population.