Pediatric Liver Transplantation in India: 22 Years and Counting.

Liver transplantation in India has grown exponentially in the last decade with 135 centers now performing between 1500-2000 transplants a year, 10% of which are pediatric. Survival rate surpassing 90% has been achieved, and India is now an important regional liver transplant hub in South and South-East Asia. The indications have expanded to include increasing number of liver-based metabolic disorders that may or may not cause liver disease. Recipients, who were previously considered non-transplantable such as those with pre-existing portal vein thrombosis, can be successfully managed with innovative microvascular techniques. The donor pool has grown with the use of marginal grafts and ABO incompatible organs. Financial constraints are being overcome by crowd funding and increasing philanthropic efforts.