RT Book, Section
A1 Healey, Patrick J.
A2 Kline, Mark W.
SR Print(0)
ID 1182909507
T1 Liver Transplantation
T2 Rudolph's Pediatrics, 23e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259588594
LK accesspediatrics.mhmedical.com/content.aspx?aid=1182909507
RD 2024/04/19
AB Liver  transplantation  is  widely  recognized  as  the  standard  of  care  for  the  management  of  irreversible  acute  liver  failure  and  end-stage  liver  disease  in  children.  Advances  in  diagnosis  and  management  of  liver  disease  in  children  and  improvements  in  transplant  surgical  technique  and  perioperative  care  have  contributed  to  improved  graft  and  patient  survival.  At  the  same  time,  recognition  of  the  importance  of  nutritional  support,  management  of  portal  hypertension  and  ascites,  and  prompt  management  of  infection  have  contributed  to  improved  overall  condition  of  children  awaiting  liver  transplant.  Changes  in  allocation  policies  and  in  transplant  center  listing  practices  have  resulted  in  more  active  management  of  the  patient’s  candidacy  and  in  broader  geographic  distribution  of  pediatric  donor  livers.  Improved  understanding  of  post-transplant  immunosuppression,  and  earlier  recognition  of  rejection,  infection,  and  vascular  and  biliary  complications  have  also  contributed  to  improved  outcomes.  Advances  in  ultrasound  and  other  radiologic  imaging  and  the  integrated  involvement  of  interventional  radiology  into  transplant  care  team  have  allowed  for  less  invasive  and  often  earlier  diagnosis  and  treatment  of  certain  post-transplant  complications.  This  improved  overall  outcome  has  allowed  for  the  expanded  consideration  of  liver  transplant  in  select  clinical  situations  for  quality-of-life  indications,  though  the  primary  indication  for  liver  transplant  remains  increased  survival  of  end-stage  liver  disease.