Thursday, September 8, 2011

Pediatric liver transplantation

Pediatric liver transplantation has been a major success and is now an established therapeutic entity. The use of innovative surgical techniques has allowed the application of liver transplantation to even very young infants with excellent results. Selection criterion for adults is properly based on outcome measures. The major driving force for this has been the mismatch between the number of donor organs and potential recipients. While the same general principles apply to children there are notable differences. The success of liver splitting allows many children to benefit from liver transplantation with little net effect on the overall donor organ pool. Also in some circumstances a smaller probability of long-term success may be a very worthwhile outcome for some children and their families. The liver is the only solid organ that can regenerate itself. That means surgeons can transplant a small segment of a donor’s liver (small enough to fit the baby or child), and the segment will grow as the child grows. Segmental transplants can use liver tissue from living or deceased donors.

The particularly high mortality in children awaiting liver and intestinal transplantation has been recognized by allocating this group a higher priority in the allocation sequence. Patients assessed for liver transplantation usually suffer from Chronic liver disease, Acute liver failure, Liver tumors and Metabolic liver disease with life-threatening extra-hepatic complications. Common symptoms that may indicate the need for further testing and possible transplant include: jaundice, ascites (accumulation of fluid in the abdomen), bleeding episodes or poor growth pattern.

The ability of the child's family to comply with instructions and follow-up plans are relevant factors which must be considered in the transplant assessment process. However the aim of the process is to identify support required to enable successful transplantation. Children should not be disadvantaged by family factors beyond their control. Age is not itself a contraindication, but the outcome of transplantation in the neonatal period is inferior to transplantation later in childhood.

Long-term monitoring is important to assure the child’s ongoing health. Outpatient medical visits and blood testing continue at a frequency that tapers over time, according to the child’s condition and absence of complications or illnesses.

Visit Hospitals in Chennai for more details.

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