Pediatric Liver Transplantation

  • Kyle A. SoltysEmail author
  • Hasan Yersiz
  • John Renz
  • George Mazariegos


Thirty years after liver transplantation (LT) was first successfully performed in a young child, it remains the treatment of choice for children with end-stage liver disease, malignancy, and liver-based metabolic diseases. After initial technical challenges were overcome, survival became limited by rejection, infectious complications, and other complications of immunosuppression. Long-term patient and graft survival dramatically improved after the introduction of cyclosporine in 1980 and tacrolimus in 1989.


Pediatric surgery Liver disease Children Orthotopic liver transplantation EHPVO Meso-Rex bypass Split liver transplant Living donor liver transplant Operative techniques 

Supplementary material

Left Lobe Living Donor Freise (Humar) (MP4 392 mb)

Liver Intestine transplant pediatric recipient (MOV 3.10 gb)

Suggested Reading

  1. Bhat R, Lautz TB, Superina RA, Liem R. Perioperative strategies and thrombophilia in children with extrahepatic portal vein obstruction undergoing the meso-rex bypass. J Gastroint Surg. 2013;17:949–55.CrossRefGoogle Scholar
  2. de Ville de Goyet J, D’Ambrosio G, Grimaldi C. Surgical management of portal hypertension in children. Semin Pediatr Surg. 2012;21:219–32.CrossRefGoogle Scholar
  3. Diamond IR, Fecteau A, Millis MJ, Losanoff JE, Ng V, Anand R, et al. Impact of graft type on outcome in pediatric transplantation: a report from Studies of Pediatric Liver Transplantation (SPLIT). Ann Surg. 2007;246:301–10.CrossRefPubMedCentralPubMedGoogle Scholar
  4. Doyle MB, Maynard E, Lin Y, Vachharajani N, Shenoy S, Anderson C, et al. Outcomes with split liver transplantation are equivalent to those with whole organ transplantation. J Am Coll Surg. 2013;217:102–14.CrossRefPubMedGoogle Scholar
  5. Lautz TB, Keys LA, Melvin JC, Ito J, Superina R. Advantages of the meso-Rex bypass compared with portosystemic shunts in the management of extrahepatic portal vein obstruction in children. J Am Coll Surg. 2013;216:83–9.CrossRefPubMedGoogle Scholar
  6. Maksoud-Filho JG, Goncalves MEP, Cardoso SR, Gibelli NEM, Tannuri U. Long-term follow-up of children with extrahepatic portal vein obstruction: impact of an endoscopic sclerotherapy program on bleeding episodes, hepatic function, hypersplenism and mortality. J Pediatr Surg. 2009;44:1877–83.CrossRefPubMedGoogle Scholar
  7. Martin SR, Atkison P, Anand R, Lindblad AS, SPLIT Research Group. Studies of Pediatric Liver Transplantation 2002: patient and graft survival and rejection in pediatric recipients of a first liver transplant in the United States and Canada. Pediatr Transplant. 2004;8:273–83.CrossRefPubMedGoogle Scholar
  8. McDiarmid SV, Anand R, Martz K, Millis MJ, Mazariegos GV. A multivariate analysis of pre-, peri- and post-transplant factors affecting outcome after pediatric liver transplantation. Ann Surg. 2011;254:145–54.CrossRefPubMedGoogle Scholar
  9. Ng V, Anand R, Fecteau A. Liver retransplantation in children: A SPLIT database analysis of outcome and predictive factors for survival. Am J Transplant. 2008a;8:386–95.CrossRefPubMedGoogle Scholar
  10. Ng V, Fecteau A, Shephard R, Magee J, Bucuvalas J, Alonso E, et al. Outcomes of 5-year survivors of pediatric liver transplantation: report on 461 children from a North American multicenter registry. Pediatrics. 2008b;122:e1128–35.CrossRefPubMedGoogle Scholar
  11. Soltys KA, Mazariegos GV, Squires RH, Sindhi RK, Anand R. Late graft loss or death in pediatric liver transplantation: an analysis of the SPLIT database. Am J Transplant. 2007;7:2165–71.CrossRefPubMedGoogle Scholar
  12. Sundaram SS, Alonso EM, Anand R, Study of Pediatric Liver Transplantation Research Group. Outcomes after liver transplantation in young infants. J Pediatr Gastroenterol Nutr. 2008;47:486–92.CrossRefPubMedGoogle Scholar
  13. Superina R, Shneider B, Emre S, Sarin S, de Ville de Goyet J J. Surgical guidelines for the management of extra-hepatic portal vein obstruction. Pediatr Transplant. 2006;10:908–13.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  • Kyle A. Soltys
    • 1
    Email author
  • Hasan Yersiz
    • 2
  • John Renz
    • 3
  • George Mazariegos
    • 1
  1. 1.Department of Surgery, Hillman Center for Pediatric TransplantationChildren’s Hospital of Pittsburgh of UPMCPittsburghUSA
  2. 2.Department of SurgeryUniversity of California–Los Angeles Liver and Pancreas TransplantLos AngelesUSA
  3. 3.Section of Transplantation, Department of SurgeryUniversity of ChicagoChicagoUSA

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