{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:34:03Z","timestamp":1792074843611,"version":"4.4.0"},"reference-count":51,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2004,3,26]],"date-time":"2004-03-26T00:00:00Z","timestamp":1080259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2004,4]]},"abstract":"<jats:p><jats:bold>Abstract:\u2002<\/jats:bold> Liver transplantation for infants and children has been available in South Africa at a single centre, the only established service in Sub\u2010Saharan Africa, for more than a decade. Current concerns have shifted from an initial target of early post\u2010transplant survival to quality of life in the long\u2010term. <jats:italic>Materials and methods<\/jats:italic>: Since 1985, 225 infants and children have been assessed, with 146 accepted for transplantation. Sixty\u2010nine have had 71 orthotopic liver transplants (OLTx). Biliary atresia was the most frequent diagnosis (54%) followed by acute liver failure (ALF) (15%). Waiting list mortality has remained high (23%), particularly for the ALF group (50%). Forty\u2010three were reduced size transplants with donor: recipient weight ratios ranging from 2:1 to 11:1. Twenty\u2010seven were &lt;10\u2003kg. <jats:italic>Results<\/jats:italic>: Fifty (74%) survive 1\u2003month\u201312\u2003years post\u2010transplant. Actuarial survival after 1996 since HBV core antibody positive donor livers were refused and prophylactic IV ganciclovir used has been &gt;82%. Early post\u2010OLTx mortality was low (5%), one primary non\u2010function, one IVC thrombosis, one PV thrombosis, but late morbidity and mortality (20%) was mainly due to viral infection: de novo hepatitis B (five patients, three deaths), EBV\u2010related post\u2010transplantation lymphoproliferative disease (PTLPD) (eight patients, six deaths) and CMV disease (11 patients, five deaths). Tuberculosis prophylaxis, required in six cases, resulted in major morbidity in two and mortality in one. Poor compliance played a significant role in seven deaths. Hypertension requiring medication along with some compromise of renal function has been present in all but two patients. However, all those of school\u2010going age (25) attend school normally and remain in good health and only three of the survivors have abnormal liver function tests. <jats:italic>Conclusions<\/jats:italic>: Successful liver transplantation is possible in a developing country with limited resources. Scarcity of virus\u2010free donors (HBV and HIV) leading to waiting list mortality and infrequent re\u2010transplantation along with long\u2010term consequences of immunosuppression (infection, lymphoma and renal toxicity) remain problems. Intense education of the caregiver and close follow\u2010up, particularly of those living at long distances has partly addressed the compliance problem.<\/jats:p>","DOI":"10.1046\/j.1399-3046.2003.00131.x","type":"journal-article","created":{"date-parts":[[2004,12,28]],"date-time":"2004-12-28T17:12:29Z","timestamp":1104253949000},"page":"136-144","source":"Crossref","is-referenced-by-count":16,"title":["Liver transplantation for children \u2013 the Red Cross Children's Hospital experience"],"prefix":"10.1111","volume":"8","author":[{"given":"A. J. 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