Key Points

1. Critical clinical outcomes for pediatric liver transplantation (LT) recipients include (1) patient and graft survival, (2) complications (immune and nonimmune) of chronic immunosuppressive medications, and (3) long-term graft function.

2. Recurrence of malignancy, sepsis, and posttransplant lymphoproliferative disorder account for more than 65% of deaths occurring more than 1 year after LT.

3. Chronic rejection, late hepatic artery thrombosis, and biliary strictures account for 70% of graft loss occurring more than 1 year after LT.

4. Late histological changes in the allograft are emerging as a common problem in patients more than 5 years after LT. The pathogenesis of these findings and the impact on graft survival remain to be determined. Liver Transpl 15:S6–S11, 2009. © 2009 AASLD.