Liver transplantation in pediatric patients.

Since the introduction of cyclosporine and a multidisciplinary surgical/medical approach, survival has improved in children undergoing orthotopic liver transplantation. In many areas, liver replacement is being considered a genuine treatment option for progressive liver disease. Before this procedure is routinely accepted, however, it will be important to follow long-term outcome and to compare results with those of conventional treatment when there are more patients in each disease category. In addition to continued experimentation with immunosuppressive regimens, methods for monitoring immunosuppression and detecting rejection at early stages are needed. Finally, the changes in bodily processes accompanying liver replacement should be used to learn more about the function of the liver, its role in immunity and its pathobiologic involvement by specific disorders.