ASPECTS PRATIQUES DE LA SURVEILLANCE APRES TRANSPLANTATION HEPATIQUE CHEZ L'ENFANT

From a practical point of view, the care of a child after liver transplantation comprises 3 periods with decreasing severity: the first one takes place in the intensive care unit: immunosuppression is started with steroids, azathioprine and cyclosporine and four major complications are sought for and treated: primary graft dysfunction, acute rejection, hepatic artery thrombosis and infection; the second period takes place in conventional hospital settings: cyclosporine is progressively switched from IV to oral; rejection, cytomegalovirus infection and biliary complications are sought for and treated; the third period takes place at home: the level of immunosuppression is progressively lowered under biochemical supervision; long-term complications (renal and malignancies) are detected.