Ruba AzzamMD Estella M AlonsoMD Karan M EmerickMD and Peter F WhitingtonMD

Liver transplantation is an effective and widely accepted treatment for children with liver disease. In just two decades, pediatric liver transplantation has matured from a clinical therapy performed in only a few centers in the United States and western Europe to one that is practiced worldwide in innumerable medical institutions. This transformation can be traced to a few critical developments. Improvements in immunosuppressive agents suitable for use in children have clearly been of key importance in improving survival after transplantation. The application of technical variant allo-grafts overcame the shortage of suitable donors for children and permitted many more children to receive transplants. Finally, there has been improved understanding of where, when, and how to use transplant therapy in children. Survival rates in children at the beginning of the 1980s approximated 30%, whereas now several centers report survival rates as high as 85 to 90%.

In this chapter, we review liver transplantation, including a general overview of indications and contraindications, a discussion of some specific indications in children, a highlight of surgical approaches that have had their greatest impact in pediatrics, and some postoperative considerations peculiar to the pediatric recipient.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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