Search

Liver diseases in children have variable clinical manifestations, from asymptomatic increase of transaminases to fulminant liver failure. The disease evolution could be very severe, even fatal without right treatment on right moment. The level of transaminases is not a very valuable for predicting the severity of the disease. In neonatal cholestasis, biliary atresia is very important as it could have a severe evolution to cirrhosis and death. The most important prognostic factors in biliary atresia are the precocity of the diagnostic, the age at the surgical intervention, the experience of the surgical team. In acute liver failure there are many prognostic scores that include level of transaminases, coagulation factors or albumin level, with some differences depending on the etiologies. One of the clinical onset forms in Wilson disease is the fulminant liver failure. The severity and the need of liver transplantation could be assessed using a dedicated prognostic score. Even considered irreversible, liver fibrosis is a dynamic process potential reversible. The quick diagnostic, correct evaluation and timely therapy could limit the unfavorable consequences of liver cirrhosis. Liver biopsy is the gold standard in fibrosis evaluation, but sometimes the risks could limit its value. Non-invasive evaluation of liver fibrosis is based on measuring the serum level of makers involved in fibrosis or on imagistic methods and tend to replace the liver biopsy. In liver cirrhosis, there are different scores used for evaluation of the severity. Among those scores, PELD (pediatric end-stage liver disease) is used to evaluate the need of liver transplantation and also the urge of it. In conclusion, knowing the prognostic factors in different liver diseases is very important in order to assess the need of high specialized care in a liver center including liver transplantation in order to increase the survival of those children. [ABSTRACT FROM AUTHOR]