Transplantation Techniques Unique in Pediatric Liver Transplantation

In previous decades, pediatric liver transplantation has become a state-of-the-art operation with excellent success and limited mortality. Graft and patient survival have continued to improve as a result of proper selection criteria for both donors and recipients, improvement in medical, surgical and anesthetic management, organ availability, balanced immunosuppression, and early identification and treatment of postoperative complications. Most of all, refinements of the technique has directly related to good outcome. Therefore rapid establishment of surgical knowhow is mandatory. In pediatric liver transplantation, the utilization of split-liver grafts and grafts for living donors has provided more organs for pediatric patients and has had a significant impact on graft and patient survival. This has been one of the brilliant outcomes of surgical evolution. In addition, new surgical technique of minimal invasive live donor surgery has been recently widening the living donor liver transplantation for children. Although the recent outcome has been rapidly improved and the volume of living donor liver transplantation has been larger and larger in Korea, pediatric liver transplantation has been performed in a very limited large volume centers. Therefore, this review focuses on surgical technique in order to share the experiences and to improve the outcome of pediatric liver transplantation.