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Journal Volume 68 - 2005
Issue Fasc.4 - Symposium
Author(s) AGEB
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MEDICAL PROGREss AND PITFALLS OF THE TREATMENT OF INBORN ERRORS INVOLVING THE LIVER J. V. Leonard. Biochemistry, Endocrinology and Metabolism Unit, Institute of Child Health, London, UK.

In the early years because of the high risk of mortality and morbidity, liver transplantation was only used for those that were terminally ill. As the outlook for liver transplantation in childhood has improved so the indications for trans- plantation for metabolic disorders in childhood have expanded (1). Liver transplantation is used to treat inborn errors for two major indications; firstly because of irreversible liver disease, usually cirrhosis, and secondly for enzyme replacement. The management may be made more complicated by the involvement of other organs by the metabolic disease. The indications for transplantation for isolated liver failure are the same as those for any other cause. The most frequent disorders are progressive familial intrahepatic cholestasis (PFIC), Wilson's disease, a1- antitrypsin deficiency and tyrosinaemia type 1. In glycogen storage disease (GSD) IV, cystic fibrosis, respiratory chain disorders, and cholesterol ester storage disease liver may be also diseased but other organs are often involved (heart, lung, etc) and may complicate transplantation.

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