Current Options for Treatment of End-Stage Liver Disease in Children

Abstract

Liver transplantation has become the accepted method of treatment for children with end-stage liver disease. Combining new methods of immunosuppression, modifications in surgical technique, improved anesthetic management, organ availability, and identification and treatment of postoperative complications, survival rates have reached 80% to 90% in many centers performing pediatric liver transplants. With the improvement in survival rates, indications for liver transplantation in children have broadened; however, the availability of organs suitable for children is still extremely limited. Although pediatric cases only represent approximately 10% of the total patients on the waiting list, the number of deaths on the waiting list increased from 196 in 1988 to 1753 in 1999. The recent development of surgical procedures that enable the use of cut down