[Childhood liver transplantation. Long-term results].
Liver transplantation allows long-term survival (10 years or more) in 75% of children receiving transplants before 2000. The risk of mortality after the first year is 4-10% in the next 10-20 years. Chronic rejection affects 6%. The need for late retransplantation is 3-5%. However, the follow-up of these patients involves the management of diverse problems in the graft (immunological, biliary, vascular) and others related to the use of immunosuppressants (renal dysfunction, lymphoproliferative syndrome). The transition from pediatric to adult care generates special needs. Adolescence and young adulthood are associated with a lack of compliance. Adult specialists should be aware of the special features of the original diagnosis and the surgical techniques used in childhood transplantation. Final quality of life is good overall but is lower than that in healthy young persons.
Jara
Paloma
P
Servicio de Hepatología y Trasplante, Hospital Infantil Universitario La Paz, Madrid, España. pjara.hulp@salud.madrid.org
Hierro
Loreto
L
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D019693:Hepatitis, Autoimmune / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology; D008107:Liver Diseases / Q000151:congenital / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000523:psychology / Q000706:statistics & numerical data*; D008232:Lymphoproliferative Disorders / Q000453:epidemiology / Q000401:mortality; D010349:Patient Compliance; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D011788:Quality of Life; D012086:Reoperation; D012307:Risk Factors; D017741:Survivors / Q000523:psychology; D016896:Treatment Outcome
D007166:Immunosuppressive Agents