Abstract
Orthotopic liver transplantation(OLT) is a therapeutic option for children with end-stage liver diseases. Once the OLT has been completed inmunosupression with prednisolone(P) and cyclosporine(C) is started. The two major problems in the postoperative period(POP)are related to rejection and drug induced hepatotoxicity (DIH) both manifested by similar byochemical and clinical symptomatology. To evaluate both problems is the aim of this paper. METHODS: The POP of 13 children that underwent OLT with succes, has been reviewed. The evidence of rejection or DIH, have been searched for. RESULTS: All patients presented in the POP a coagulopathy rise in serum transaminases, gamaGT, alkaline phosphatase and bilirrubin. 12 of them improved with P bolus, and later on, C levels and liver biopsy, proved to be a rejection crisis. Other one did not improve with P bolus, and subsequent C dosage and liver biopsy, confirmed DIH. CONCLUSIONS: If ther is doubt on rejection or DIH, P bolus must be administered in order to treat a possible rejection crisis, till the liver biopsy and other byochemical paramenters stablish the diagnosis with accuracy.
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