Current concepts in pediatric liver transplant.
Orthotopic liver transplantation has significantly improved the survival rate of children with end-stage liver disease. Efforts to correct abnormalities existing prior to transplantation coupled with improved surgical techniques and immunosuppression have led to better quality of life and 1-year survival rates approaching 90% in many centers. Despite this success the expanding waiting list population of all ages has driven development of operative techniques to expand the donor pool. Building on the success of reduced-size transplantation, split-liver and living-donor transplantation are now suitable alternatives, especially when used in candidates with satisfactory clinical stability. In the post-operative period, infectious complications represent an important cause of morbidity and mortality. Although antimicrobial regimens are effective in the immediate post-operative phase, acquisition of viral infections represents a major concern particularly in the young liver recipient. Early detection and development of new anti-viral agents are likely to decrease occurrence of post-transplant proliferative disorders and optimize longterm transplantation outcome.
Alonso
M H
MH
Liver Transplant Services, Children's Hospital Medical Center, University of Cincinnati, Ohio 45229, USA.
Ryckman
F C
FC
D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017114:Liver Failure, Acute / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods / Q000592:standards; D018579:Patient Selection; D011183:Postoperative Complications / Q000517:prevention & control; D011379:Prognosis; D011788:Quality of Life
D000998:Antiviral Agents; D007166:Immunosuppressive Agents