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Medical audit needs to encompass physical, psychological and social aspects to patient functioning. The aim of this paper is to review the psychosocial impact of liver transplantation on children and their families. Evidence suggests that end stage liver diseases are associated with developmental delays. Emotional and behavioural problems are common and have been found to relate to the child's developmental status, physical appearance as well as family functioning. Post transplant, children and families often experience an exacerbation of preexisting emotional problems. One year post transplant, children typically show continuing developmental delays. Longer term assessments of quality of life suggest that children may experience fewer hospital contacts and that over time psychological difficulties reduce. Many families continue to experience problems in normalizing their interactions within and outside the family. The findings demonstrate the importance of including psychosocial outcomes in auditing the efficacy of medical interventions.