Pediatric liver disease.

Pediatric hepatology has advanced greatly over the past few years. Many more children with severe liver disease are now surviving into adulthood. There is a number of conditions not seen in adult practice that have been the focus of research efforts, and many of these efforts have borne fruit in the past year. Disorders characterized by intrahepatic cholestasis in particular have now been substantially unravelled, and this work has elucidated a great deal about hepatic physiology. Liver-directed gene therapy is on the threshold of human application. This research has been facilitated by excellent animal models and the advent of isolated hepatocyte transplantation. Relatively common conditions such as biliary atresia, however, remain largely unexplained and the viral hepatitides have no effective form of treatment. It remains a hope that our increase in knowledge in the fields of genetics and immunology will translate into advances in therapy.