[Liver transplantation].

OBJECTIVE

To review the clinical aspects and the theoretical basis of liver transplantation in children, focusing mainly pre and post surgical periods.

METHODS

References were obtained from computerized search in the National Library of Medicine (Medline), recent review articles, and personal files.

RESULTS

Great development has occurred in surgical techniques, in organ preservation, in postoperative care, and in immunosuppression methods after the first liver transplantation surgery took place in a child with biliary atresia in 1963. Liver transplantation has become an efficient therapy, widely accepted and used in all age groups. It is a very complex procedure, with many professionals involved and with several legal, ethical and economical implications. We review in this article the clinical aspects before transplantation, including indications, contraindications, clinical and laboratory evaluations, as well as postsurgical aspects, both in the immediate period, after the 1st week, and the long-term outcome, discussing the complications and the treatment of each.

CONCLUSIONS

Liver transplantation has dramatically improved the survival of pediatric patients with chronic hepatic diseases. Patients of liver transplantation in the pediatric age group present today survival rates of 90% in the different transplantation centers.