Intensive care issues in post-operative pediatric liver transplantation

Abstract

Pediatric liver transplantation has evolved over the last few decades from an experimental therapy to standard of care in end stage liver disease. Apart from surgical expertise, the success of liver transplantation largely depends on perioperative care of the patient. Intensive care management plays a key role in supporting the pre-operative sick patient through the surgery and till the new liver graft starts to function and there is resolution of pre-operative morbidities. Pediatric patients are more challenging than the adult counterparts and demand minute attention to fluid volume status, hemodynamics and various organ-specific and graft specific issues. This review describes the various principles and challenges in the post-operative intensive care management of pediatric patients undergoing liver transplantation.

Keywords

• pediatric intensive care unit
• liver transplant
• immunosuppression
• post operative complications