ABSTRACT

One of the prime stimuli for the development of liver transplantation was the inevitable mortality from infant liver disease, and many of the advances in liver transplantation techniques were prompted by the need to tailor the procedure for the pediatric patient. In infancy, the most frequent reasons for liver transplantation are infantile liver failure due to neonatal hemochromatosis and biliary atresia. Children with chronic liver disease are prioritized for liver transplantation according to the Pediatric End-Stage Liver Disease (PELD) or Model for End-Stage Liver Disease (MELD) score. Surgical complications may be reduced to an absolute minimum with meticulous technique. Patients are monitored intensively postoperatively and usually require ventilation for a period of 24–48 hours. Liver ultrasound with color flow Doppler is performed frequently to confirm vascular patency and the absence of biliary dilatation. Transplantation in infancy appears to result in a reduced incidence of nonadherence in adolescence compared with later transplantation.