Evaluation of the Pediatric Patient for Liver Transplantation

PREAMBLE Current American Association for the Study of Liver Diseases (AASLD) liver transplant evaluation guidelines include both adult and pediatric patients (1). While pediatric liver transplants account for ∼7.8% of all liver transplants in the United States, sufficient differences between pediatric and adult patients seeking liver transplantation (LT) now require independent, yet complementary documents. This document will focus on pediatric issues at each level of the evaluation process. Disease categories suitable for referral to a pediatric LT program are similar to adults: acute liver failure (ALF), autoimmune, cholestasis, metabolic or genetic, oncologic, vascular, and infectious; however, specific etiologies and outcomes differ widely from adult patients, justifying independent pediatric guidelines. Data supporting our recommendations are based on a MEDLINE search of the English language literature from 1997 to the present. Intended for use by physicians, these recommendations suggest preferred approaches to the diagnostic, therapeutic, and preventive aspects of care. They are intended to be flexible, in contrast to standards of care, which are inflexible policies to be followed in every case. Specific recommendations are based on relevant published information. To more fully characterize the available evidence supporting the recommendations, the AASLD Practice Guidelines Committee has adopted the classification used by the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) workgroup and recommendations are based on the of evidence in the of evidence by or and the of recommendations or Grading of Assessment, and Evaluation at to on the of the by the of the for and the from of or relevant to the relevant to liver transplant evaluation in the pediatric patients a all of the on and the based on and literature and the search are literature available to all of the They of and and the to the Data supporting our recommendations are based on a MEDLINE search of the literature from to the present. search liver transplant liver and liver transplant each and in the of the search relevant of for the based on a of the of the for the a relevant of patients and in the and on preferred and in of these from be in recommendations are on 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