Introduction Although the liver is known to be a somewhat immunotolerant organ, pediatric liver transplantation (LT) would not have reached current success without efficient immunosuppressive drugs. Standard protocols include calcineurin inhibitors (CNIs), most often tacrolimus (TAC) and sometimes cyclosporine A…
Immunological Mechanisms of Rejection Transplantation of an allograft induces a formidable immunological response by the recipient designed to destroy the foreign organ efficiently and quickly. Successfully controlling this complex multifaceted cascade is the critical element required for graft survival. It…
Introduction Liver transplantation (LT) is a major surgical procedure, with recipients presenting with end-stage liver disease and the complications thereof. It follows that post-operative care is complex and requires continuous anticipation of potential co-morbidities and complications. Although the immediate post-operative…
Introduction Anesthesia for pediatric liver transplantation is complex, diverse, and challenging. The indications for transplantation and the physiology of children vary from the adult population, making the pediatric service unique. The role of the anesthetist must begin with the preassessment…
Introduction Pediatric liver transplantation (PLT) sits at the pinnacle of pediatric surgical endeavors. In the early years, long-term survival rates after PLT were 11% to 39% and, since then, have improved to up to 90% with long-term graft survival rates…
Introduction Intestinal transplantation (ITx) was first attempted in the 1970s in children with intestinal failure (IF) for whom intravenous nutrition was not available. The early efforts did not meet with long-term success because of lack of adequate immunosuppression. The first…
Liver-Heart Indication Combined heart and liver transplantation (CHLT) is still an evolving procedure, representing only 0.3% of all cardiac transplantation in a Unified Network for Organ Sharing (UNOS) database study spanning 28 years. The most common indications are cirrhosis secondary…
Whereas isolated liver and kidney transplantations (LTs and KTs, respectively) have become routine procedures for isolated organ failure, combined liver and kidney transplantation (CLKT) is relatively rarely performed worldwide, and the number of centers undertaking this procedure is limited. In…
Liver and hematopoietic stem cell transplantation (HSCT) have established their places in the ever-increasing number of individual indications in their respective fields of modern medicine. However, there is a group of overlapping conditions in immunology, hematology, metabolic medicine, and oncology…
Introduction The transplantation of ABO-identical or ABO-nonidentical ABO-compatible grafts has for decades been the mainstay of organ transplantation. As post-transplant survival improves and the demand for organ transplants grows, several attempts have historically been made to transplant liver grafts from…