Mortality from liver disease in children. Implications for hepatic transplantation programs.

Mortality from liver disease in a pediatric hospital was reviewed to assess the implications for hepatic transplantation programs. Between 1976 and 1983, 81 children died of hepatic failure that included biliary atresia (n = 20), metabolic disorders (n = 22), Reye's syndrome (n = 7), infections (n = 15), cholestatic syndromes (n = 12), and miscellaneous causes (n = 5). Hepatic failure was considered the secondary cause of death in only five patients. Acute hepatic failure was present in 42% (34/81) of patients, whereas 58% (47/81) had preexisting chronic liver disease. Forty (49.4%) of the 81 patients died in infancy, including two thirds of the patients with biliary atresia. Liver disease accounted for 6.6% (81/1,225) of all deaths in our hospital during this eight-year period. During this interval, eight patients (six alive) underwent liver transplantation. Approximately 2.9 patients per year will be candidates for liver transplantation.