End stage liver failure

Advances in surgical techniques and immunosuppressive agents have led to paediatric liver transplantation being a standard treatment option for both acute and chronic liver failure with good long term outcome and quality of life. It is important to recognise the early clinical presentation and aetiology of hepatic disease so that accurate diagnosis and management may be initiated and referral to a specialist centre made. Children with liver disease should have shared care between a regional and specialist centre with timely referral for transplant assessment and further management when complications arise.