Defining the Society of Pediatric Liver Transplantation (SPLIT) research agenda: A Delphi consensus project. Hepatol Commun 2026 Mar 01;10(3)
Date
02/23/2026Pubmed ID
41730231Pubmed Central ID
PMC12922923DOI
10.1097/HC9.0000000000000914Abstract
BACKGROUND: Despite major advances in surgical and medical management, only one-third of pediatric liver transplant (LT) recipients remain morbidity-free at 10 years. The Society of Pediatric Liver Transplantation (SPLIT) published a research agenda over 10 years ago, and much progress has been made since then. An updated consensus-driven SPLIT research agenda could guide future research and funding priorities. We aimed to identify and prioritize key research needs across the continuum of pediatric LT care using a modified Delphi consensus approach.
METHODS: We conducted a three-round modified Delphi process among SPLIT members. In round 1, participants submitted open-ended research priorities. In round 2, the Steering Committee synthesized these into 156 unique statements for rating. The third and final round included revision and rerating of 42 statements. Consensus was defined as a median importance rating ≥7 on a 9-point Likert scale.
RESULTS: Sixty-nine multidisciplinary experts participated in round 1, with <30% attrition across rounds. The panel identified 46 high-priority research topics, organized into 7 domains: (1) end-stage disease and waitlist management; (2) transplant access, allocation, and organ utilization; (3) perioperative management; (4) immunosuppression management; (5) transplant complications; (6) long-term health and transition to adulthood; and (7) special populations. Highest-ranked research priorities included (1) developing an updated LT waitlist allocation scoring tool, (2) identifying novel biomarkers to guide immunosuppression minimization/withdrawal, and (3) developing new organ preservation strategies to increase the availability of high-quality organs for pediatric LT candidates.
CONCLUSIONS: SPLIT members identified 46 consensus research priorities that define the next frontier of pediatric LT research and provide a roadmap for investigators, funders, and health systems to improve survival and lifelong health in children after LT.
Author List
Wadhwani SI, Spector PR, Feldman AG, Furuya KN, Hartjes K, Jarasvaraparn C, Kelly B, Lerret SM, Mysore K, Pawaria A, Rosenthal P, Shui A, Slowik V, Taylor S, Vittorio J, Valentino PL, Society of Pediatric Liver Transplantation (SPLIT)Author
Stacee Lerret PhD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Biomedical ResearchChild
Consensus
Delphi Technique
End Stage Liver Disease
Humans
Liver Transplantation
Pediatrics
Societies, Medical
Waiting Lists
