Pediatric liver transplantation

Abstract

Liver transplantation in children has become a treatment of choice for end-stage liver disease. Both graft and patient survival has significantly improved over the last two decades. The major factor contributing towards improved survival is availability of cyclosporin. Surgical innovations like living related donation has not only increased the donor pool, but has also helped patients in countries where cadaveric donation is not available. Auxiliary liver transplantation has made a significant change to the management of children with liver-based metabolic disorders and, in selected cases of acute liver failure, immunosuppression can be safely withdrawn once the native liver recovers. However, the complications associated with immunosuppression, such as nephrotoxicity, lymphoproliferative disease and viral infections, continue to be a matter of great concern. Most children with good graft function enjoy near normal quality of life.