Pediatric liver transplantation at the University of Chicago Hospitals.

The concept of graft-reduction surgery in liver transplantation has revolutionized pediatric transplantation and soon may carry over into adult transplantation. Reduced-size liver transplants have virtually eliminated patient deaths while waiting for donor organs to become available by increasing the potential donor pool. This has shifted the distribution of pediatric liver transplant recipients to a younger age which more closely matches the needs of pediatric patients with end-stage liver disease. Split-liver transplants can create new grafts without increasing the donor supply. Living-donor liver transplantation not only increases the supply of organs but also creates uniformly good quality grafts that can be used electively in stable patients. The result is patient and graft survival rates that are better than those seen with cadaveric organs. Orthotopic auxiliary liver transplantation offers children with metabolic disorders the opportunity to correct their diseases without the risks associated with whole-organ replacement.