ResumoObjetivo: Analisar a evolução de pacientes pediátricos avaliados para Transplante Hepático.Métodos: Foram revisados os prontuários das primeiras 65 crianças e adolescentes portadores de hepatopatias crônicas, com idades de 5 meses a 19 anos (x= 6,8 AbstractObjective: To analyze the evolution of pediatric patients chosen for hepatic transplantation.Methods: A review was made of the clinical charts of the first 65 children and adolescents with chronic liver disease, aged 5 months to 19 years (X = 6.8%), chosen for liver transplantation during the period of August 1994 to March 1996. Data refer to the patients' demographic characteristics, etiology of their liver disease, their psychosocial situation and of their parents, and their clinical and laboratorial evaluation. According to the severity of the disease, patients were classified as active (waiting for a donor), in evaluation, inactive (compensated liver disease), and excluded for psychosocial or medical conditions, or because of bad indication.Results: Eight patients (12%) received transplantation, and one of them died. Seven (11%) died when in evaluation or waiting for a donor. Ten patients (15%) were excluded from the waiting list: 6 for social problems, and 4 for medical problems. No patient was excluded for bad indication. Six patients are in the active list, waiting for donor. The other 23 patients (35%) are in evaluation, and 11 (17%) are classified as inactive in the waiting list.Conclusions: Eleven patients (17%) were not operated on due to the advanced stage of the liver disease. We emphasize the necessity of organ donation, and the early contact of the patients with a reference center.J. pediatr. (Rio J.). 1997; 73(2): 75-79: pediatric liver transplantation, chronic liver disease. IntroduçãoO transplante de fígado melhorou dramaticamente a taxa de sobrevida das crianças e adolescentes com doenças hepáticas terminais 1 . Pacientes que antigamente tinham prognóstico obrigatoriamente fatal hoje podem ser submetidos a um transplante hepático que apresenta 85 a 90% de sobrevida após 1 ano, na maior parte dos centros 1,2 .Os critérios de seleção dos candidatos ao transplante hepático determinam em grande parte as taxas de sucesso desse tratamento em um determinado centro 3 . A tarefa de definir quais pacientes vão necessitar e se beneficiar com um transplante e quando ele deve ser realizado não é simples e é o objetivo primeiro do processo de avaliação 1 .Concordamos com Whitington e Alonso 4 quando dizem que os fatores que indicam a necessidade de um