1. Sinusoidal obstructive syndrome (SOS)/Veno-occlusive disease (VOD) is a potentially fatal complication of hematopoietic stem cell transplant (HSCT) and chemotherapy treatment that can cause multi-organ failure, including pulmonary and renal dysfunction.

2. Suspect SOS/VOD in patients with recent stem cell transplant or chemotherapy presenting with hepatomegaly, ascites, and weight gain.

3. SOS/VOD diagnostic criteria is separated into classic and late onset SOS/VOD, which involves the presence of hyperbilirubinemia plus two or more findings of ascites, weight gain, and right upper quadrant abdominal pain.

4. Management of fluid status is critical and should be started before diagnosis is confirmed

5. Defibrotide is potentially lifesaving. Unless SOS/VOD is mild, begin this mediation when more than two diagnostic criteria are present.

This chapter provides anoverview of the surgical treatment for biliary atresia, the Hepatic Portoenterostomy or Kasai Procedure. The pathophysiology of biliary atresia is reviewed as it related to the organ systems effected. The signs and symptoms of neonatal liver failure are discussed including the development of hepatorenal and hepatopulmonary syndromes. The chapter provides anoverview of the surgical aspects and anesthetic concerns related to the Kasai procedure. The chapter provides a segue into the chapter on liver transplantation.

This chapter, provides an overview of the basics of pharmacology and physiology in the neonate. The authors focus on the physiological differences between children and adults using a background case of omphalocele. Key concepts for pediatric anesthesia are considered including, hyperbilirubinemia, oxygenation, hepatic function and metabolism and thyroid function.