Zusammenfassung
Pediatric liver transplantation (pLTx) has become the standard-of-care therapeutic modality for children with end-stage liver disease and a number of inherited metabolic liver diseases. The main indications for pLTx are cholestatic cirrhosis. The most important factors influencing graft and patient survival are (1) the primary diagnosis and the individual physical status at the time of pLTx and ...
Zusammenfassung
Pediatric liver transplantation (pLTx) has become the standard-of-care therapeutic modality for children with end-stage liver disease and a number of inherited metabolic liver diseases. The main indications for pLTx are cholestatic cirrhosis. The most important factors influencing graft and patient survival are (1) the primary diagnosis and the individual physical status at the time of pLTx and (2) continuous medical follow-up by an experienced pediatric liver transplant center. The remarkable success of pLTx over the last two decades is due largely to advances in immunosuppression, innovative surgical techniques, and improvement of pediatric intensive care medicine and pediatric hepatology. Pediatric LTx is so successful that by far the largest proportion of patients survive adolescence and adulthood. However, children face a long potential lifespan following LTx and, consequently, liver transplantation burdens children with lifelong immunosuppression. Thus, the focus of post-LTx care in pediatric patients has shifted to encompass consequences related to the transplantation itself and to the post-transplant course. Main factors affecting late post-transplant survival are renal dysfunction and post-transplant lymphoproliferative disease (PTLD).
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