الفهرس 
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Abstract
LTx is a treatment, used in
appropriately selected patients, for acute and chronic liver failure. It is not indicated if an acceptable alternative is available or if contraindications are present. Ideally LDLT is associated with improvement of graft and patient survival. Infection and rejection are important and potentially inter-related adverse events occurring after LTx. Infections remain a significant cause of morbidity and mortality in patients undergoing LTx. Knowledge of the type, timing, and predisposing factors for these infections will help in early prediction, appropriate diagnosis and management. Infection in the LTx patient is diagnosed in the same way as in the non-transplanted population. However, it tends to be laborious work-up due to the wide differential diagnosis and the attenuation of clinical manifestations because of the immunosuppressive medication. The choice of antimicrobial regimens is often more complex than in other patients due to increased antimicrobial resistance, urgency of therapy and the high frequency of drug related toxicities and interactions with immunosuppressant drugs. Although the liver is not as antigenic as other solid organs, assessment for rejection of the transplanted liver is a major focus of patient care. Rejection is a major cause of graft failure and a frequent reason for retransplantation. Identification of risk factors for rejection in pediatric transplant recipients is vital to understand the pathogenesis of rejection and may help to prevent further graft loss. The aim of this work was to study the risk factors for post transplant rejection and infection in pediatric LRLT in order to delinate strategies that help to increase the success rate of LRLT and prevent or minimize post-operative morbidities and mortalitites. Twenty-six pediatric patients who underwent LDLT at the “National Liver Institute”, Menoufia University, between April 2003 and June 2011 were included in the study. The study was longitudinal (cohort), conducted retrospectively. All patients’ records were reviewed, including the entire medical and nursing staff records, the medical prescriptions, laboratory and radiological test results. Follow-up data were submitted in 1.5 years. A wide range of potential pre-LT and post-LT recipient risk factors, donor and surgical risk factors were selected to be evaluated in a risk analysis for both rejection and infection. Pre-operative data of the recipient included the age, gender, etiological diagnosis, blood grouping, pre-LT infectious state, pre-LT steroid therapy, prior abdominal surgery, co-morbedity, immunization status, prophylactic antibiotics, growth state and presence of ascitis. Post-operative data included type, dose and duration of immunosuppressant, period of hospitalization, presence of ascitis, multiorgan failure and post-operative complications. Routine ultrasound and laboratory investigations as complete blood count, liver function tests, prothrombin time, renal function tests and viral markers were done pre-LT, two weeks post-LT and upon every rejection and infection attack. Donor data includes the relation to the recipient, age, gender, blood.