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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. May 14, 2026; 32(18): 116902
Published online May 14, 2026. doi: 10.3748/wjg.v32.i18.116902
Outcomes of pediatric liver transplant recipients who reach adulthood: Current perspectives and unmet needs
Alberto Ferrarese, Mara Cananzi, Luca Bosa, Marco Senzolo, Giacomo Germani, Laura Marta Vivian, Claudia Mescoli, Annalisa Dolcet, Enrico Gringeri, Lorenzo D’Antiga, Marco Spada, Jorge Amil Dias, Umberto Cillo, Patrizia Burra
Alberto Ferrarese, Giacomo Germani, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, Padova 35122, Veneto, Italy
Mara Cananzi, Luca Bosa, Department of Pediatric Hepatology, Padova University Hospital, Padova 35122, Veneto, Italy
Marco Senzolo, Laura Marta Vivian, Patrizia Burra, Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, Padova 35122, Veneto, Italy
Claudia Mescoli, Pathology Unit, Padova University Hospital, Padova 35122, Veneto, Italy
Annalisa Dolcet, Enrico Gringeri, Umberto Cillo, Hepatobiliary Surgery and Liver Transplant Center, Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, Padova 35122, Veneto, Italy
Lorenzo D’Antiga, Department of Pediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, Bergamo 24127, Italy
Marco Spada, Division of Hepatobiliopancreatic Surgery, Liver and Kidney Transplantation, “Bambino Gesù” Children’s Hospital, IRCCS, Rome 00165, Italy
Jorge Amil Dias, Department of Gastroenterology, Hospital Lusiadas, Porto 4000-008, Portugal
Co-corresponding authors: Alberto Ferrarese and Patrizia Burra.
Author contributions: Ferrarese A, Senzolo M, Germani G, Cillo U, Gringeri E, Dias JA, and Burra P contributed to the conceptualization of the manuscript; Ferrarese A, Cananzi M, Bosa L, Vivian LM, Dolcet A, Mescoli C, D’Antiga L, and Spada M contributed to the writing of the manuscript and its critical revision; Ferrarese A and Burra P contributed equally as co-corresponding authors. All authors approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Alberto Ferrarese, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, Via Giustiniani 2, Padova 35122, Veneto, Italy. alberto.ferrarese@unipd.it
Received: November 26, 2025
Revised: January 7, 2026
Accepted: February 24, 2026
Published online: May 14, 2026
Processing time: 161 Days and 16.4 Hours
Core Tip

Core Tip: Pediatric liver transplantation has progressed from a life-saving procedure to one offering excellent long-term survival, with most recipients reaching adulthood. The focus has shifted from survival to global health, encompassing medical outcomes, psychological well-being, social integration, quality of life, and long-term functional and developmental success. However, only a minority achieve the ideal outcome, largely due to medical complications. Graft-related issues (such as persistent liver function test abnormalities) and extrahepatic complications, including chronic kidney disease, and metabolic disorders, and de novo cancers, often result from long-term immunosuppression. This minireview highlights determinants of long-term outcomes and proposes refinements to better assess the ideal outcome.

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