Liver Transplantation in children differs from that in adults primarily due the mismatch in size of both the organ and vessels.
Chronic liver failure despite surgical correction of Biliary Atresia, and inborn disorders of metabolism are the most common reason for transplantation in children.
v Age at first transplant is often less than 12 months.
v There are very few paediatric cadaveric donors
v A whole liver from an adult donor will be too large for a paediatric recipient.

Inadequate numbers of available organs requires careful management. The trend is to split a cadaveric liver to allow the larger right lobe to be transplanted into an adult recipient and the smaller left lobe to be used for a paediatric patient. The success of this relies upon the knowledge of the recipient vascular anatomy, so graft vessels can be planned for preoperatively.
Living Related Liver Transplants, most often used in cases of acute liver failure when time is of the essence, are becoming more common.
A cut down liver with multiple anastomoses , frequently leads to predictable and unpredictable short and long term complications.
Imaging for liver transplant workup, initial post operative assessment, short and long term complications are discussed from the Australian paediatric perspective.