Long term outcomes after pediatric liver transplantation

Area of Science:

• Pediatric Gastroenterology and Hepatology
• Transplantation Medicine
• Immunology

Background:

• Short-term outcomes of pediatric liver transplantation are excellent.
• Focus is shifting towards understanding and improving long-term outcomes.
• Quality of life and long-term graft survival are paramount.

Purpose of the Study:

• To review long-term outcomes in pediatric liver transplantation.
• To highlight proposed treatments and areas requiring further investigation.
• To emphasize the importance of quality of life as a measure of treatment success.

Main Methods:

• Systematic review of English literature.
• PubMed database search from 2000-2013.
• Inclusion of studies on long-term outcomes in pediatric liver transplant patients.

Main Results:

• Chronic liver dysfunction due to rejection, autoimmune hepatitis, and recurrent disease.
• Metabolic syndrome increases cardiovascular complication risk.
• Secondary infections, kidney dysfunction, malignancy, and cognitive/executive function delays are significant concerns.
• Quality of life remains comparable to children with chronic diseases despite good health status.

Conclusions:

• Long-term outcomes represent the new frontier in pediatric liver transplantation.
• Improvements are needed in graft survival and reducing morbidities from long-term immunosuppression.
• Quality of life requires innovative interventions and approaches considering patients and their social circles.