This article describes the preliminary experimental steps and clinical implementation of a purely pediatric liver transplantation (LT) program in a large public children's hospital in Buenos Aires, Argentina, a city with well over 10 million inhabitants and a referral population of over 30 million. Between 1993 and 1997, 84 LTs were performed in 81 patients, of which one-fourth weighed below 10 kg. The main indications were biliary atresia (n = 25, 30%) and fulminant liver failure (n = 23, 27%), followed by autoimmune cirrhosis (n = 14, 16%) and other liver diseases. Shortage of organs due to local conditions led to the use of liver-reduction techniques in 48 cases (57%), split liver in 2, and living-related donor (LRD) in 2. Retransplantation was necessary in 3 instances. Seventy-eight percent of the recipients survived for more than 1 year and 71% were alive after 4 years. The authors comment on the need for adaptation to local conditioning factors when developing a pediatric LT program in any country in which demographics and economic, medical, and sociological environments have a decisive influence on organ procurement, the actual performance of the operation, and the lifelong postoperative medication. In Buenos Aires, where the hospital setting is well-developed, the indications are in part determined by the high incidence of hepatitis A. Organ shortages in our area led to liberal use of liver reduction, split-liver, and LRD techniques. The overall results of the first years of such a program were largely satisfactory.

In a previous work we pointed out the hlgh correlation among the presence of antithyroid antibodies (AB), thyrold function alteration and clinical symptans in children with insulin dependent diabetes mellitus (DMID). In the actual study, the chronic lymphocitic thyrolditis (CLT), antithyroid AC and alteration function in patients wlth DMID was evaluated. From a total of 228 pts,in 78 (age 11.6 + 4.31, basal TSH and/or post TRH, T4, T3 by RIE and microscmal antifraction (MiAE) antithyroid AC and antlthyrcqlobulin (A'lg) haemoglutlnation was done. CLT presence (Fisher's criteria) was determined in 20 pts (25%): 16 girls, 4 boys; 11,6 years + 3. 43, 90% (18/20) of which presented thyroid functlon alteration with high basal TSH -X 7.39 + 3.49 u W (p-x 0.001) and or frank hyper response to TRH (>of 25 uLknl). 85% of the patients presented cllnical symptans; goiter was detected in 65%. CLT prevalence was significatively greater in the first four years of the diabetes evolution. The frequency of MiAF positive titles was 15.4% of the diabetlc and 50% of CLT patients. m e to the high prevalence, 258, we conclude that thyroid function study, AC dosage and clinical exam must be lncluded In all the children with DMID, specially in the flrst four years after the onset of the dlsease. In all patlents during the first year of life(range:O-10 months,X:3 nonths).Seven died before one year of age,and two when they were 3 years old(range:O-36 months,X:1,7 years).source of infection was: blood transfusion in 3(2 nothers and 1 child),tatm in both parents in 1,drug adlctlon in parents in 4,durg adiction and prctrusculty in 1.Autopsles were performed and processed routinely.5/9 had hepathomegaly;3/9 splenomegaly;2/9 cardimqa1y;and 1 child had lntraventrlcular bleedlnq.Lwphoid depletion in nodes was observed In 5/9 while heperplasia in lj9~Thymic involution was observed In 1/9 while 4/9 had lymphold depletion in their thymuses. In 1/9 the thymus was normal. Hepatic steatosis was observed in 7/9 and non speclflc hepatitis ln 6/9.Dlffuse alveolar damage was recorded in 4/9,PHL/LIP In 2/9 and lung angimtosis in 2/9.Acute myocarditls was found in 2/9 and myocardial lnfarctlon in 1/9. Sepsis by CMV was found in 3/9, and South Pmerican trypanosmiasis, histoplasmosis,congenital syphllls and pneumxystis carinii,one case each.We did not see neoplastic diseases,proMly becuase of the early age of death of our cases. Abut 80-90% of post-transfusional hepatitis and 50% of sporadlc hepatltis,so called non A non B Hepatitis, are produced by HVC. The prevalence of Anti-HVC is about 0.4-2.28 in blccd donors.AEter an acuteHVC infection,50-60%of patlentswill progress to a chronic state,and 20% of then wlll have an hepatic cirrhosis.The objetive of this study was to evaluate the anti HVC prevalence in different high risk groups.subjects and Methcds:131 patients considered as high risk groups were selected:a)69 wlth hepatic disease (fD,34 boys,r:lm -18y);b)23 wlth hemato-oncolqic disease (H-0,13 boys,r:2.5-16y);c) 39 with chronic renal failure (CRF,19 b...