Transplant Research and Risk Management (Dec 2019)
Improving Patient Outcomes Following Pediatric Liver Transplant: Current Perspectives
Abstract
Alex G Cuenca,1,2 Heidi Yeh1 1Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA; 2Department of Surgery, Boston Children’s Hospital, Boston, MA, USACorrespondence: Heidi Yeh Email [email protected]: Over the last 50 years, considerable advances have been made in pediatric liver transplantation. The long-term 10-year patient and graft survival following pediatric liver transplant have improved considerably to greater than 90% and 75%, respectively. With longer living grafts, patients are now struggling with different issues, such as the consequences and morbidity of immunosuppression and/or chronic hospitalization. This review will discuss some of the current outcomes and obstacles in pediatric liver transplantation, such as sequelae of long-term maintenance immunosuppression, worsened neurocognitive development, and shortages in allografts that lead to waitlist mortality. Though the future is bright and certainly better than it once was, there are clearly areas of in the long-term clinical care of these patients that deserve focus and attention. This review will highlight some of these concepts, as well as novel strategies to treat and address some of these issues in this complex and fragile patient population.Keywords: liver transplant, outcomes, immunosuppression, neurodevelopmental, socioeconomic, pediatric
