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Chapter-33 Pediatric Liver Transplantation

BOOK TITLE: Liver Transplantation

Author
1. K Dilip Chakravarty
2. Lee WC
3. Jan YY
4. Lee Po-Huang
ISBN
9788184487701
DOI
10.5005/jp/books/10445_33
Edition
1/e
Publishing Year
2010
Pages
8
Author Affiliations
1. Chang Gung Memorial Hospital (Linkou), Taipei, Taiwan (ROC)
2. Chang Gung Transplantation Institute (Linkou), Chang Gung University, Taipei, Taiwan (ROC)
3. Chang Gung Memorial Hospital (Linkou), Chang Gung University, Taipei, Taiwan (ROC)
4. National Taiwan University Hospital, Taipei, Taiwan (ROC)
Chapter keywords

Abstract

Pediatric patients had unacceptably high morbidity and mortality rates while awaiting LTX due to shortage of liver allografts. This donor-recipient disparity in children reportedly caused pre-transplant mortality rates as high as 25–50%. Children with ESLD may manifest with several serious complications such as malnutrition, recurrent infections particularly related to biliary tract, signs of portal hypertension, renal problems, vascular complications and osteopenia. All these issues need to be focused during transplantation in children. The prevalence of medical complications is as high as 60–80% in pediatric patients. Extra-hepatic biliary atresia (EHBA) is the most common indication for liver transplantation in children and accounts for >50% cases of pediatric transplants. But majority of children (>80%) are asymptomatic at birth. Infection or infection induced immunological theory is the cause for cholestatic cirrhosis in these patients. Compliance is very important in any solid organ transplantation. Lack of compliance to immunosuppressive medications is the leading cause of late morbidity in children and adolescents after solid organ transplantation. The estimated rate of noncompliance varies from 5% to 29%. Noncompliant (Non-adherent) behavior has been linked to negative outcomes in transplantation, primarily rejection, which leads to graft loss.

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