Paediatric liver transplantation: an overview

The only definitive treatment for end stage liver disease is transplantation. This has been made possible by advances in vascular surgery and immunosuppression. In the paediatric population, liver transplantation is most commonly performed for liver failure secondary to biliary atresia. Successful transplantation depends on patient preparation by a dedicated multidisciplinary team and meticulous peri-operative care. Improvements in timing of transplantation, immunosuppression advances and peri-operative intensive care have all contributed to improvements in patient survival. Currently the survival rates for children undergoing deceased donor liver transplant in the UK is 95.7% at 1 year and 91.8% at 5 years. These outcomes are reliant on multi-disciplinary care, which is best provided in centres that provide the expertise in each of the specialist fields required to care for these children. This article provides an overview of the entire process. It describes the selection process, the surgery undertaken and early and late post-operative complications.