Advances in Pediatric Liver Transplantation

Advancements in surgical techniques, anesthetic agents, and immunosuppression have resulted in excellent survival after pediatric liver transplant. However, children continue to die on the transplant waiting list, and infants continue to have the highest waitlist mortality of all age groups. Increased utilization of living donors, technical variant grafts, and machine perfusion technology offer opportunities to increase the pool of size-appropriate organs for children. Collaboration with interventional radiology provides new methods to manage biliary and vascular complications. Policy changes at the national level are needed to prioritize pediatric candidates to receive organs and to mandate split liver transplant when possible.