There are several late medical complications that may jeopardize long-term survival after pediatric liver transplantation (LT). A significant number of recipients develop subclinical but progressive graft fibrosis, as increasingly evidenced in protocol liver biopsies performed 1 to 10 years post-LT,…
The recurrence of underlying disease is relatively low in cases of pediatric liver transplantation (LT) compared with adults. The underlying liver disease does not recur in biliary atresia or in most forms of metabolic liver disease. The most important indications…
Introduction Long-term outcomes after pediatric liver transplantation are nowadays characterized by their excellence. Remarkably, when compared with older age group results, graft and patient midterm survival rates are higher, with a remarkably low loss in the longer term (for both…
Introduction This chapter will briefly consider the examination of the recipient’s liver, removed at transplantation, and then focus on the role of the pathologist in the interpretation of the liver allograft biopsy. Complications following liver transplantation have been described in…
Introduction Solid organ transplants can be associated with a variety of hematologic abnormalities ranging from minor to life-threatening. When they occur, they may lead to prolonged admissions, reduced physical capacity, infectious complications, risk of bleeding, and overall impact the child’s…
Introduction Liver transplantation (LT) should not be considered a procedure that resolves the problem of a native liver at once but rather a “long-term care plan.” Indeed, the surgical procedure is only the first step of a complex management program…
Introduction Pediatric liver transplantation (LT) has expanded since 1980 because of the broad utilization of segmental grafts including split, living donor, and, occasionally, also reduced grafts. This currently allows achievement of a timely transplant in virtually all the children on…
This chapter treats early vascular complications after pediatric liver transplantation (PLT), which herein will be defined as complications that occur during the first 4 weeks after liver transplantation (LT). General Considerations PLT is characterized by coagulation disorders. Preoperatively, routine coagulation…
Anti-infection Strategies Infections are the cause of significant morbidity and mortality after transplantation, both in the immediate post-operative period and beyond ( Fig. 19.1 ). Anti-infection strategies include preventive measures, such as antimicrobial prophylaxis or vaccination (see Chapter 6 ),…
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…