Advances in pediatric liver and intestinal transplantation

Citation
Rm. Ghobrial et al., Advances in pediatric liver and intestinal transplantation, AM J SURG, 180(5), 2000, pp. 328-334
Citations number
37
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
AMERICAN JOURNAL OF SURGERY
ISSN journal
00029610 → ACNP
Volume
180
Issue
5
Year of publication
2000
Pages
328 - 334
Database
ISI
SICI code
0002-9610(200011)180:5<328:AIPLAI>2.0.ZU;2-N
Abstract
BACKGROUND: Significant progress has been made with liver and intestinal tr ansplantation in pediatric patients. Shortage of whole-organ cadaveric graf ts has resulted in a high mortality rate for children awaiting transplantat ion. New surgical procedures such as split-liver transplantation and living -related liver transplantation have evolved over the last decade to maximiz e donor utilization in pediatric patients. METHODS: In this article we review the current indications and contraindica tions for liver and intestinal transplantation in children, the surgical in novations to expand an exceedingly small cadaveric liver pool, postoperativ e management, and the impact on patient and graft survival. RESULTS: Reduced-size liver transplantation provides children with much nee ded small grafts; however, split-liver transplantation may eliminate the ne ed for reduced-size and living-related liver transplantation except in urge nt situations. CONCLUSION: Liver transplantation is a durable procedure that provides exce llent long-term survival. The use of living-related and split-liver transpl antation has dramatically reduced the waiting periods for children and impr oved Survival. In the past decade significant progress has been made with i ntestinal transplantation owing to improvements in surgical technique, immu nosuppressive agents, and early identification and treatment of postoperati ve complications. Am J Surg. 2000;180:328-334. (C) 2000 by Excerpta Medica, Inc.