Psychological guidelines in the management of paediatric organ transplantation.

Organ transplantation is increasingly being seen as the preferred treatment for several life threatening disorders of childhood. Though the early history of liver transplantation in the United Kingdom was not promising (only seven transplants were carried out on children under the age of 16 by 1983 and none survived longer than seven weeks), current one year survival rates exceed 60%. 1 Heart and heart-lung transplantation are now also avail- able for some children, and increasing rates of success are being reported.2 The advances that can be achieved are best seen in renal transplantation, in which the actuarial survival rate for children who received transplants between November 1968-December 1987 is 79% after 14 years, and for those who received transplants since October 1983, is 94% after four years.3