Late Transplant Considerations

  • Emily M. Fredericks
  • John C. Bucuvalas
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)


Technical factors impact early graft and patient outcomes significantly but also need to be assessed in the long term. In children, the leading cause of mortality that occurs more than 1 year after liver transplantation is attributed to complications of immunosuppression rather than disease recurrence or allograft rejection. Children face increased risk of morbidity given their potential for longer life expectancy thereby increasing the likelihood for greater cumulative exposure to immunosuppressive agents. Evaluation of allograft dysfunction is complex and requires assessment of technical and immune factors, infectious etiologies, recurrent disease, and impact of nonadherence. This chapter discusses the risk of late graft dysfunction and related complications, health-related quality of life (HRQOL), adherence, and the transition from pediatric to adult health care.


Allograft dysfunction Biliary complications Immunosuppression Health-related quality of life Adherence Transition 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Michigan Health SystemsAnn ArborUSA
  2. 2.Division of Pediatric Gastroenterology, Hepatology and NutritionCincinnati Children’s HospitalCincinnatiUSA

Section editors and affiliations

  • Vicky Lee Ng
    • 1
  • John Bucuvalas
    • 2
  1. 1.Division of Gastroenterology, Hepatology and NutritionThe Hospital for Sick ChildrenTorontoCanada
  2. 2.Pediatric Liver Care CenterCincinnati Children's Hospital Medical CenterCincinnatiUSA

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