PEDIATRICS Vol. 78 No. 4 October 1986, pp. 559-565
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Evaluation of the Pediatric Patient for Liver Transplantation

Basil J. Zitelli MD1, J. Jeffrey Malatack MD1, J. Carlton Gartner Jr MD1, Andrew H. Urbach MD1, Laurel Williams RN, MSN1, Joanne W. Miller PhD1, and Beverly Kirkpatrick MSW1

1 From the Departments of Pediatrics, Nursing, Psychiatry, and Social Service, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh

In a 36-month period from 1981 to 1984, 209 pediatric patients were evaluated for liver transplantation. The purpose of the evaluation was to assess the severity and progression of the disease, anatomical suitability for transplantation, and psychosocial stability and to initiate family education. Of the 209 patients evaluated, 85 (41%) underwent transplantations and 64 (75%) survived at least 12 months. Thirty-four (16%) patients were not considered candidates for transplantation. The mean waiting period increased from 80.3 days to 232 days. Of 174 patients considered for transplantation, 41 (24%) died prior to surgery. A formal evaluation for liver transplantation permitted appropriate selection of candidates and provided education for informed consent. We also stress the need for greater participation in pediatric organ donation.

Key Words: liver transplantation • liver failure • biliary atresia • transplant evaluation

Submitted on October 21, 1985
Accepted on February 6, 1986