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Pediatric Gastroenterologist and the Infant and Child Before Liver and Small Bowel Transplantation

  • Sana Mansoor
  • Katryn N. Furuya
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)

Abstract

Pediatric liver transplantation is the standard of care for children with acute liver failure or end-stage liver disease and has excellent outcomes with 5-year survival rates greater than 85%. The most common cause for liver transplantation in children is biliary atresia unlike in adults where end-stage liver disease is most commonly due to nonalcoholic steatohepatitis (NASH). Similarly, intestinal transplantation is offered to those children with intestinal failure who were unable to achieve intestinal rehabilitation or who were born with congenital/inherited diseases such as microvillus inclusion disease. Three-year survival rates with pediatric intestinal transplantation are greater than 65%. The role of the pediatric gastroenterologist/hepatologist is in the early recognition of children who meet the criteria for transplantation and refer them to an appropriate transplantation center for assessment and evaluation. Pediatric gastroenterologists/hepatologists work in a team setting with pediatric surgeons/transplant surgeons, nutritionists, social work, other pediatric providers and nursing to provide children who are awaiting transplantation optimization of their clinical status and to prevent or treat complications associated with end-stage liver disease or intestinal failure which play a critical role in posttransplant outcomes. This chapter focuses on these topics in detail.

Keywords

Liver transplantation Small intestinal transplantation Cirrhosis Portal hypertension Intestinal rehabilitation Varices Hepatopulmonary syndrome Portopulmonary syndrome Hepatorenal syndrome Hepatic encephalopathy Ascites Coagulopathy Nutrition PELD MELD 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Pediatric GastroenterologyNemours Alfred I. duPont Hospital for ChildrenWilmingtonUSA
  2. 2.Division of Pediatric GastroenterologyMayo ClinicRochesterUSA

Section editors and affiliations

  • J Jeffrey Malatack
    • 1
  1. 1.Diagnostic Referral DivisionNemours/Alfred I. duPont Hospital for ChildrenWilmingtonUSA

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