Introduction: Pediatric transplantation is a highly specialized field requiring advanced medical expertise, multidisciplinary collaboration, and ongoing professional development. Access to training opportunities, whether structured or informal, in both surgical and medical pediatric transplant subspecialties is hypothesized to vary significantly across the globe. This could lead to disparities in access to transplantation and patient outcomes. Key barriers include lack of local experts, facilities, financial constraints, training regulatory limitations, and insufficient integration of transplant education into medical curricula.
Aims: The global pediatric transplantation survey is an initiative developed by the IPTA Advocacy committee and aims to review global access to pediatric transplantation with an initial pilot evaluation of training opportunities as it has a direct impact on access to pediatric transplantation.
Results: Currently, responses from 59 different transplant centres globally representing 27 countries across six continents has been collected. The field of pediatric nephrology had the highest representation with 49% (n=29) of hospitals offering training in pediatric nephrology followed by 31% (n=18) in transplant surgery, 27% (n=16) in pediatric hepatology and 22% (n=13) in bone marrow transplantation. The least prevalent training opportunities included 15% (n=9) in pediatric cardiology, 14% (n=8) in pulmonology and 12% (n=7) in infectious disease. There are significant inter-continental variations as well as between high income and low- and middle-income countries with less opportunities reportedly present on the African and Asian continents.
Conclusion: These results provide preliminary insight into pediatric transplantation training opportunities globally and serve as a platform to facilitate future discussions and advocacy for increased access to training. In comparison to centres performing transplantation, the availability of training opportunities in the responding centres, is strikingly lower. There are also vast areas lacking access to pediatric transplantation training overall. In addition to better understanding pediatric transplant training opportunities globally, characterizing formal program qualifications versus informal training pathways remains one of the greatest challenges faced by the pediatric transplant community. Existing IPTA programs aimed at addressing gaps in training access include the SMARTER initiatives and international partnerships fostered through the Outreach Program and Fellowship. Further efforts to bridge this gap should integrate local affiliation with existing adult transplant programs, international telementoring platforms, and scholarship programs aimed at enhancing workforce capacity in resource-limited settings. Addressing these disparities through global collaboration and investment in training programs is essential to improving pediatric transplant accessibility and outcomes worldwide.