TY - CHAP M1 - Book, Section TI - Liver Transplantation A1 - Healey, Patrick J. A2 - Kline, Mark W. PY - 2018 T2 - Rudolph's Pediatrics, 23e 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. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1182909507 ER -