INTENSIVE-CARE PRIOR TO AND AFTER ORTHOTOPIC LIVER-TRANSPLANTATION IN CHILDREN

Physiological and metabolic disorders must be identified and treated prior to liver transplantation (if necessary plasmaphaeresis, hemofiltration in the case of severe hepatic failure). Postoperatively, the goal is to restore and maintain metabolic functions, to prevent any organ failure and to detect early complications. Primary liver dysfunction must be recognized as soon as possible in order to decide upon retransplantation. Hepatic artery thrombosis must be detected by doppler ultrasonography and managed surgically. Acute liver rejection must be identified and treated. Nosocomial infection should be avoided and specifically treated. The success of liver transplantation depends on the indications, patient selection, and the close cooperation between the members of the transplantation team.