ABSTRACT
Orthotopic liver transplantation has significantly improved the survival rate of children
with end-stage liver disease. Efforts to correct abnormalities existing prior to transplantation
coupled with improved surgical techniques and immunosuppression have led to better
quality of life and 1-year survival rates approaching 90% in many centers. Despite
this success the expanding waiting list population of all ages has driven development
of operative techniques to expand the donor pool. Building on the success of reduced-size
transplantation, split-liver and living-donor transplantation are now suitable alternatives,
especially when used in candidates with satisfactory clinical stability. In the post-operative
period, infectious complications represent an important cause of morbidity and mortality.
Although antimicrobial regimens are effective in the immediate post-operative phase,
acquisition of viral infections represents a major concern particularly in the young
liver recipient. Early detection and development of new anti-viral agents are likely
to decrease occurrence of post-transplant proliferative disorders and optimize long-term
transplantation outcome.
KEY WORDS
transplantation - liver - children - immunosuppression
