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Pediatric Liver Transplantation in Countries with Low Resources: Medical Issues Before and After Transplant

  • Vidyut Bhatia
  • Akshay Kapoor
  • Sarath Gopalan
  • Anupam Sibal
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)

Abstract

Liver transplantation is now a well-established therapy for children with acute liver, end-stage liver disease, and a variety of metabolic disorders. The first successful liver transplant in India was performed in an 18-month-old child with end-stage liver disease secondary to biliary atresia in November 1998 at Apollo Hospitals, New Delhi. That child remains well 17 years posttransplantation. Over the years, the indications have expanded, and successful living-related liver transplantation has been reported for acute liver failure and metabolic disorders such as Crigler-Najjar syndrome. Age and size are no longer barriers as babies as young as 6 months have been transplanted. Excellent survival figures have been reported in children weighing less than 7.5 kg. Fathers have now started to come forward as donors. Children from different parts of India and more than 20 countries have been transplanted. The average cost of a pediatric transplant in India is 23,000 to 27,000 USD. This is only about one fifth to one tenth the cost in the West. With 5-year survival rates of 90%, India has now become a major center for LT for international patients as well. With increasing acceptance of LT among the medical community and the public at large, there is now potential for the number of liver transplants to increase significantly so as to offer hope to the thousands of children who suffer from liver failure.

Keywords

Liver transplant Biliary atresia Acute liver failure Immunosuppression Tolerance Hepatocyte transplantation Complications Posttransplant metabolic syndrome 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Vidyut Bhatia
    • 1
  • Akshay Kapoor
    • 1
  • Sarath Gopalan
    • 1
  • Anupam Sibal
    • 1
    • 2
  1. 1.Apollo Center for Advanced PediatricsIndraprastha Apollo HospitalsNew DelhiIndia
  2. 2.Faculty of Medicine and Health SciencesMacquarie UniversitySydneyAustralia

Section editors and affiliations

  • Ashley L J D'Cruz
    • 1
  1. 1.Solid Organ Transplant ProgramNarayana Hrudayalaya Woman and Child InstituteBangaloreIndia

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