Background : Liver transplantation is considered the standard treatment for end-stage liver disease. The current shortage of organ donors has led to the use of split grafts and living related donors for timely liver transplantation in children. Here we report our experience with pediatric LDLT over a 6-year period.

Methods : During the period from 2017 to 2023, we performed 16 pediatric LDLT. The age of the patients ranged from 6 months to 14 years, body weight from 6 kg to 44 kg. 10 children were diagnosed with biliary atresia and biliary cirrhosis of the liver. Autoimmune hepatitis was detected in 4 children, and liver hepatoblastoma without metastasis in 2 cases. All transplantations were performed from a living related donor. In 1 case, the right lobe of the liver was removed from the donor and implanted into a child aged 14 years. All other patients underwent transplantation of the left lobe or 2-3 segments of the liver

Results : Of 16 patients, mortality was 2 cases (12.5%). The cause of mortality was multiple organ failure and severe infection with the development of sepsis. Biliary complications were detected in 5 patients (35.7%), portal vein thrombosis in 1 patient and hepatic artery thrombosis in 1 case. The remaining children had no complications. There was no mortality among donors. Complications in the form of beloma were detected in 3 patients (18.7%).

Conclusions : Our results demonstrated that pediatric LT is a feasible undertaking in Kazakhstan. The organ shortage in our area led to liberal use of living donors