Liver transplantation has become a standard surgical treatment for pediatric patients with hepatic failure, tumors, and metabolic derangements. Liver transplantation in the pediatric population can be extremely challenging for the anesthesiologist due to multiple perioperative considerations. The first successful liver transplant was performed in a pediatric patient in the 1960s, and since then, there have been significant advances in immunosuppressant medications and preservation solutions which have led to improved survival. Nevertheless, the number of liver transplants continues to be limited by organ availability, although the pediatric donor pool has been increased by living related donors and split livers. The most common pediatric pathology that results in hepatic failure and transplantation is biliary atresia. This chapter covers the perioperative care of a pediatric patient undergoing a liver transplant, from the preoperative preparation to the intraoperative management, and discusses postoperative challenges which may be encountered while in the intensive care unit.
Liver transplantation as a novel strategy for resolution of congenital afibrinogenemia in a pediatric patient
