Indications for liver transplantation in childhood.

Retrospective analysis of 97 children aged 3 months to 15 years presented for liver transplantation in our clinic indicates that children with extrahepatic biliary atresia (BA) show a cumulative survival of only 27% after 2.5 years of observation without transplantation. Children with cirrhosis of the liver of other origin (C) have an even worse cumulative survival rate of only 10% after the same time and treatment. Liver transplantation seems to be very urgent if there is a parallel drop of activity of pseudocholinesterase (CHE) below 1100 U/l, a drop of prothrombin test (PT) below 60% and a concomitant increase of concentration of bilirubin (Bili) and total serum bile acids (TBA) to 380 and 120 mumol/l respectively. In order to improve medical care of children with endstage liver disease it is mandatory to use all potential donor offers and to develop new surgical techniques such as transplantation of liver segments.