2D-SWE reliably detects significant liver graft fibrosis in pediatric liver transplant recipients, including split-liver cases. This non-invasive method shows promise for improving long-term outcomes and reducing the need for surveillance biopsies, though it does not replace the necessity of liver biopsies.

It is safe and effective to perform LDLT in MMA patients. Early LDLT within 2 years of disease onset is recommended to achieve favorable outcomes.

A new anticoagulation protocol has helped reduce hepatic artery thrombosis rates and hospital length of stay in pediatric liver transplant recipients. To achieve better outcomes, recent emphasis has been placed on early extubation, and increased use of split liver grafts, which has successfully expanded the donor pool.

Left lobe split deceased grafts can achieve the same outcomes as live donor grafts and should be considered in an intention-to-split policy to decrease time on the waiting list for young children when a live donor is not available.

This paper provides an overview of neurocognitive functioning in youth with end-stage organ dysfunction with discussion of implications for adolescent transplant recipients. While neurocognitive functioning may improve post-transplantation, it is important to understand the trajectory of neurocognitive development starting in transplant candidacy to evaluate the implications of early deficits.

We present our series of LT for MSUD, highlighting their neurodevelopmental profiles and growth aspects within the socio-economic-cultural constraints prevalent in the Indian subcontinent. Despite poorer pre-LT profiles, all children attained new development skills and maintained a stable metabolic profile on an unrestricted protein diet. However, catch-up growth remained suboptimal.

This study describes the prognosis for pediatric patients with acute liver failure by transplant era and shows improved outcomes in recent era due to the advancement in perioperative management and surgical techniques.

Haploidentical stem cell transplants are promising but should be restricted to leukemia patients first, then benign conditions. Avoid in DSA-positive patients to prevent graft rejection. Use bone marrow as the primary stem cell source to reduce the risk of GVHD.

The results support the policy of avoiding HLA combinations that preclude immune recognition of graft lymphocytes as foreign to decrease the risk of GVHD after living donor liver transplantation.