Spada M, Riva S, Maggiore G, Cintorino D, Gridelli B. Pediatric liver transplantation. World J Gastroenterol 2009; 15(6): 648-674 [PMID: 19222089 DOI: 10.3748/wjg.15.648]
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Marco Spada, MD, PhD, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione-IsMeTT, Via E. Tricomi 1, 90127 Palermo, Italy. mspada@ismett.edu
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Spada M, Riva S, Maggiore G, Cintorino D, Gridelli B. Pediatric liver transplantation. World J Gastroenterol 2009; 15(6): 648-674 [PMID: 19222089 DOI: 10.3748/wjg.15.648]
World J Gastroenterol. Feb 14, 2009; 15(6): 648-674 Published online Feb 14, 2009. doi: 10.3748/wjg.15.648
Pediatric liver transplantation
Marco Spada, Silvia Riva, Giuseppe Maggiore, Davide Cintorino, Bruno Gridelli
Marco Spada, Silvia Riva, Davide Cintorino, Bruno Gridelli, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione-IsMeTT, University of Pittsburgh Medical Center, 90127 Palermo, Italy
Giuseppe Maggiore, Department of Reproductive Medicine and Child Development, University of Pisa, 56100 Pisa, Italy
Author contributions: Spada M and Gridelli B were the principal authors of the paper, and wrote the following sections: introduction, prioritization, the transplant operation, early post-operative period, managing immunosuppressive therapy, late allograft dysfunction, outcome following transplantation; edited the final manuscript; Riva S and Maggiore G wrote the following sections: indications for liver transplantation, contraindications to liver transplantation, evaluation of the transplant candidate, infections, post-transplant lymphoproliferative disorders; Cintorino D was involved in much of the data acquisition and participated in the writing of the surgical sections of the manuscript; all authors gave their final approval for the paper.
Correspondence to: Marco Spada, MD, PhD, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione-IsMeTT, Via E. Tricomi 1, 90127 Palermo, Italy. mspada@ismett.edu
Telephone: +39-91-2192111
Fax: +39-91-2192400
Received: July 4, 2008 Revised: December 3, 2008 Accepted: December 10, 2008 Published online: February 14, 2009
Abstract
In previous decades, pediatric liver transplantation has become a state-of-the-art operation with excellent success and limited mortality. Graft and patient survival have continued to improve as a result of improvements in medical, surgical and anesthetic management, organ availability, immunosuppression, and identification and treatment of postoperative complications. The utilization of split-liver grafts and living-related donors has provided more organs for pediatric patients. Newer immunosuppression regimens, including induction therapy, have had a significant impact on graft and patient survival. Future developments of pediatric liver transplantation will deal with long-term follow-up, with prevention of immunosuppression-related complications and promotion of as normal growth as possible. This review describes the state-of-the-art in pediatric liver transplantation.
