Hackl C, Schlitt HJ, Melter M, Knoppke B, Loss M. Current developments in pediatric liver transplantation. World J Hepatol 2015; 7(11): 1509-1520 [PMID: 26085910 DOI: 10.4254/wjh.v7.i11.1509]
Corresponding Author of This Article
Martin Loss, MD, Department of Surgery, University Hospital Regensburg, Franz Josef Strauss Allee 11, 93053 Regensburg, Germany. martin.loss@ukr.de
Research Domain of This Article
Transplantation
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jun 18, 2015; 7(11): 1509-1520 Published online Jun 18, 2015. doi: 10.4254/wjh.v7.i11.1509
Current developments in pediatric liver transplantation
Christina Hackl, Hans J Schlitt, Michael Melter, Birgit Knoppke, Martin Loss
Christina Hackl, Hans J Schlitt, Martin Loss, Department of Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
Michael Melter, Birgit Knoppke, KUNO - Children’s University Hospital Regensburg, 93053 Regensburg, Germany
Author contributions: Hackl C contributed to conception and design, acquisition of data, drafting the article, critical revision for important intellectual content, final approval of the version to be published; Schlitt HJ contributed to conception and design, critical revision for important intellectual content, final approval of the version to be published; Melter M contributed to drafting of the article, critical revision for important intellectual content, final approval of the version to be published; Knoppke B contributed to critical revision for important intellectual content, final approval of the version to be published; Loss M contributed to conception and design, drafting the article, critical revision for important intellectual content, final approval of the version to be published.
Conflict-of-interest: The authors declare that they have no conflict on interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Martin Loss, MD, Department of Surgery, University Hospital Regensburg, Franz Josef Strauss Allee 11, 93053 Regensburg, Germany. martin.loss@ukr.de
Telephone: +49-941-9446801 Fax: +49-941-9446802
Received: October 1, 2014 Peer-review started: October 3, 2014 First decision: November 14, 2014 Revised: March 2, 2015 Accepted: March 18, 2015 Article in press: March 20, 2015 Published online: June 18, 2015 Processing time: 258 Days and 8.5 Hours
Abstract
In 1953, the pioneer of human orthotopic liver transplantation (LT), Thomas E Starzl, was the first to attempt an orthotopic liver transplant into a 3 years old patient suffering from biliary atresia. Thus, the first LT in humans was attempted in a disease, which, up until today, remains the main indication for pediatric LT (pLT). During the last sixty years, refinements in diagnostics and surgical technique, the introduction of new immunosuppressive medications and improvements in perioperative pediatric care have established LT as routine procedure for childhood acute and chronic liver failure as well as inherited liver diseases. In contrast to adult recipients, pLT differs greatly in indications for LT, allocation practice, surgical technique, immunosuppression and post-operative life-long aftercare. Many aspects are focus of ongoing preclinical and clinical research. The present review gives an overview of current developments and the clinical outcome of pLT, with a focus on alternatives to full-size deceased-donor organ transplantation.
Core tip: As of today, pediatric liver transplantation (pLT) has become a safe and routine procedure for the treatment of childhood acute and chronic liver failure as well as inherited liver diseases. In contrast to adult recipients, pLT differs greatly in indications for LT, allocation practice, surgical technique, immunosuppression and post-operative life-long aftercare. Long-term survival after pLT implies life-long aftercare in an interdisciplinary team. The present review gives an insight into current indications for pLT, outcome after living-donor and deceased-donor organ transplantation and of ongoing clinical and preclinical developments to improve long-term outcome.
