Pediatric Infectious Diseases: Open Access

Introduction

Pediatric liver transplantation has advanced to the point where it is now a state-of-the-art procedure with a high success rate and low mortality. Medical, surgical, and anaesthetic care, organ availability, immunosuppression, and the diagnosis and treatment of postoperative problems have all improved graft and patient survival. More organs for juvenile patients have been made available because to the use of split-liver grafts and living-related donors. Newer immunosuppressive regimens, like as induction treatment, have improved graft and patient survival significantly. Long-term follow-up, prevention of immunosuppression-related problems, and promotion will all be part of the future of pediatric liver transplantation. of as natural a development as feasible

The first pediatric liver transplant is in a 3-year-old boy with congenital biliary atresia who died in the surgery room in 1963. 4 years later, there is success with the first recipient who had a significant chance of survival. Because to advancements in surgical methods, organ preservation, pediatric critical care, and immunosuppressive medication, survival rates have improved since then. Furthermore, developments in radiography and the presence of radiologists on the multidisciplinary team have improved patient outcomes by allowing for the early detection of problems.

In the United States, around 7.8% of liver transplants are performed on children. Cholestatic liver disease (such as biliary atresia), which accounts for about half of the patients, metabolic and genetic disorders, fulminant liver failure, and malignancies are the most common clinical indications for liver transplant in this population, in decreasing order of prevalence. The 1-year, 5-year, and 10-year survival rates for deceased-donor transplant recipients were 89.3%, 78.1%, and 68.4%, respectively, according to the 2013 Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients Annual Data Report, while the corresponding rates for living-donor transplant recipients were 93.1%, 85.7%, and 67.5%.

Despite these results, which are better than earlier data, liver transplantation remains a complex procedure with high morbidity and mortality. Approximately 40% of pediatric patients may experience postoperative problems, which can range from minor to severe. Given the scarcity of donors for a second transplant, early detection of these problems is critical for patient survival. Considering the lower graft survival rate for repeat transplant recipients: a first transplant had a 5-year survival rate of 76.4% against 64.5% for a repeat transplant. Because the majority of patients are asymptomatic or oligosymptomatic, and laboratory data are nonspecific, radiologists play a critical role in recognising problems in this setting.

In pediatric liver transplants, a variety of surgical methods are performed. Whole-liver transplantation, split adult cadaveric organ grafting, and living-donor transplantation (segments II and III or segments II–IV) are the most prevalent. The radiologist interprets images obtained with various modalities using his or her knowledge of the various surgical methods utilised in pediatric liver transplants.