LIVER-TRANSPLANTATION IN CHILDREN

The need for paediatric liver transplantation, which in most paediatri c series is the remedy for biliary atresia after Kasai's operation has failed, is not sufficiently covered by organ retrieval at the present time, In most cases, survival after liver transplantation in children is approximately 80%. Mortality is still high due to intra-operative complications in most cases. Morbidity is related to vascular complica tions as well as to different types of infections which occur in nearl y all the children. After the initial period, growth in most children returns to normal with normal physical and intellectual development, T here remain a number of questions concerning the future of liver trans plantation in children. What are the limits for proper indications and contraindications? What is the risk of Life-long immunosuppressive tr eatment? Are there alternative modalities of treatment other orthotopi c liver transplantation? It must be admitted that before progress has provided answers to these questions and a better understanding of the aetiology of many congenital or metabolic diseases in children as well as a better means of treatment or prevention, that the need for liver grafts in children will continue to rise as a consequence of its own success. One point must be emphasized, since we are concerned with ver y young children, care should always be given by specially trained hea lth care providers.