Beschreibung:
<jats:title>Abstract</jats:title><jats:p>Liver allocation in the Eurotransplant (<jats:styled-content style="fixed-case">ET</jats:styled-content>) region has changed from a waiting time to an urgency‐based system using the model of end‐stage liver disease (<jats:styled-content style="fixed-case">MELD</jats:styled-content>) score in 2006. To allow timely transplantation, pediatric recipients are allocated by an assigned pediatric <jats:styled-content style="fixed-case">MELD</jats:styled-content> independent of severity of illness. Consequences for children listed at our center were evaluated by retrospective analysis of all primary pediatric liver transplantation (<jats:styled-content style="fixed-case">LTX</jats:styled-content>) from deceased donors between 2002 and 2010 (110 <jats:styled-content style="fixed-case">LTX</jats:styled-content> before/50 <jats:styled-content style="fixed-case">LTX</jats:styled-content> after new allocation). Of 50 children transplanted in the <jats:styled-content style="fixed-case">MELD</jats:styled-content> era, 17 (34%) underwent <jats:styled-content style="fixed-case">LTX</jats:styled-content> with a high‐urgent status that was real in five patients (median lab <jats:styled-content style="fixed-case">MELD</jats:styled-content> 22, waiting time five d) and assigned in 12 patients (lab <jats:styled-content style="fixed-case">MELD</jats:styled-content> 7, waiting time 35 d). Thirty‐three children received a liver by their assigned pediatric <jats:styled-content style="fixed-case">MELD</jats:styled-content> (lab <jats:styled-content style="fixed-case">MELD</jats:styled-content> 15, waiting time 255 d). Waiting time in the two periods was similar, whereas the wait‐list mortality decreased (from about four children/yr to about one child/yr). One‐ and three‐yr patient survival showed no significant difference (94.5/97.7%; p<jats:italic> </jats:italic>=<jats:italic> </jats:italic>0.385) as did one‐ and three‐yr graft survival (80.7/75.2%; and 86.5/82%; p<jats:italic> </jats:italic>=<jats:italic> </jats:italic>0.436 before/after). Introduction of a <jats:styled-content style="fixed-case">MELD</jats:styled-content>‐based allocation system in <jats:styled-content style="fixed-case">ET</jats:styled-content> with assignment of a granted score for pediatric recipients has led to a clear priorization of children resulting in a low wait‐list mortality and good clinical outcome.</jats:p>