Pediatric Transplant Surgery


Pediatric Liver Transplant

The NewYork-Presbyterian Center for Liver Disease and Transplantation, located at NewYork-Presbyterian Morgan Stanley Children's Hospital and NewYork-Presbyterian Komansky Children's Hospital, is one of the largest and most successful liver transplant centers in North America and the world. To date, our team has performed 500 pediatric liver transplants. Here, your child is in expert hands, as we are committed to providing our patients with the safest, most advanced techniques available to extend survival and quality of life.

For some children with liver disease, a liver transplant can be lifesaving. Both of our locations provide multidisciplinary teams of pediatric specialists skilled in the management of children with all degrees of liver injury

We are committed to providing your child with the safest, most advanced techniques in pediatric liver transplant surgery—to promote longevity and quality of life.

The NYP Transplant team celebrating their 500th successful liver transplant.

What is Pediatric Liver Transplant?

What is Pediatric Liver Transplant?

A pediatric liver transplant is a surgical procedure where an end-stage diseased liver is replaced with a healthy one. The healthy liver may come from a recently deceased donor. In some cases, a section of a liver can come from a healthy living donor, usually a family member. 

A child may require a liver transplant when they have a condition or disease that damages the liver or causes it to function improperly. The most common reason for a pediatric liver transplant is a rare disease called biliary atresia, but there are many others.

What We Treat

What We Treat

At NewYork-Presbyterian, our liver specialists have expertise in the treatment of a wide range of liver conditions and disorders in children of all ages. Some of the most common liver diseases we treat are:

  • Acute Liver Failure: when the liver suddenly stops functioning over the course of a few days.
  • Alagille Syndrome: an inherited liver disorder in which bile builds up in the liver. It affects the liver, heart and other parts of the body.
  • Alpha-1 Antitrypsin Deficiency: in this inherited condition, the liver produces an abnormal form of the alpha-1 antitrypsin protein.
  • Bile Acid Synthesis Defects (BASD): rare metabolic disorders that cause accumulation of abnormal bile acids and other substances that can damage organ systems.
  • Biliary Atresia: this condition, which affects infants, prevents the liver from draining bile to the intestines.
  • Cystic Fibrosis: an inherited disease that causes mucus to build up throughout the body, and can affect multiple organs.
  • Liver Cancer: the abnormal growth of cells in liver tissue. Hepatocellular carcinoma is the most common type of liver cancer.
  • Portal Hypertension: elevated blood pressure in the portal vein, the major vein that carries blood to the liver.
  • Viral Hepatitis: an infection that causes liver swelling and damage. There are several different viruses that can produce hepatitis.
  • Wilson's Disease: a genetic disorder that prevents the body from excreting copper, causing it to build up in tissue.

How is a Pediatric Liver Transplant Performed?


For liver transplant surgery, your child will be given general anesthesia before the following steps in the transplant process are performed: 

  1. The transplant surgeon makes an incision on the upper part of the abdomen (belly). 
  2. The blood vessels and bile ducts leading to the diseased liver are detached.
  3. The diseased liver is removed, leaving portions of the major blood vessels in place.
  4. The old liver is replaced with a healthy donor liver.
  5. The surgeon reattaches the detached blood vessels and bile ducts to the new liver.
  6. The incision is closed with surgical thread or medical glue. 

Pediatric liver transplant surgery can typically last between six to eight hours. 

Living Donor Liver Program 

A living donor liver transplant is when a healthy living person donates part of their liver for surgical transplantation into a needy recipient. NewYork-Presbyterian’s Living Donor Liver Program is one of the largest in America, offering patients:

  • Innovative transplant programs. We were the first transplant program in the country to offer fully laparoscopic (minimally invasive) living donor surgery.
  • Exceptional volume and experience. Nearly a quarter of our pediatric transplants are from living donors.
  • A track record of success. Our program has consistently exceeded the national and expected outcomes for liver transplantation.

Risks to Consider


Liver transplant procedures come with some risks. It’s important to discuss them with your doctor and pediatric transplant surgeons. 

Risks of pediatric liver transplant can include:

  • Liver rejection
  • Infection
  • Bleeding
  • Bile leakage
  • Wound healing issues
  • Primary graft dysfunction when the liver doesn’t function after surgery
  • Medication side effects 

These risks can lead to longer hospital stays, increased recovery time, and, rarely, death.

Preparing for Pediatric Liver Transplant

Preparing for Pediatric Liver Transplant

Before your child undergoes a pediatric liver transplant, there are usually some preparatory steps and tests to be taken before the procedure, to ensure your child is ready for surgery. 

These steps and evaluations can include:

  • Blood tests
  • Immunizations
  • Heart testing: EKG (electrocardiogram) and echocardiogram.
  • Viral studies, particularly for Hepatitis A, B, and C, chicken pox, HIV, herpes simplex, CMV (cytomegalovirus) and Epstein Barr.
  • Chest X-ray, to check the functioning of the heart and lungs.
  • Imaging tests of the liver, such as an ultrasound, CT scan or MRI.

What to Expect After Pediatric Liver Transplant

After the Surgery

Every child is different, but the typical recovery process after a pediatric liver transplant for most patients can involve:

  • A seven- to 14-day initial hospital stay for children called in from home, longer for infants.
  • Your child being closely monitored in the PICU (pediatric intensive care unit) by your liver transplant team.
  • Skillful and compassionate management to actively minimize fear and pain.
  • Rapid mobilization within days of the surgery
  • A physician assistant and pharmacist going over your child’s at-home medication plan.
  • Your child continuing to take immunosuppressants, most likely for the reminder of their lives.
  • Your child adapting a healthy diet and exercise regime, avoiding activities that could harm the new liver. 

Pediatric liver transplants are safe and effective. With continual care, the procedure cures pediatric liver failure, permits normal growth and development, and provides long-term patient survival benefit.

What Sets Us Apart

What Sets Us Apart

NewYork-Presbyterian Morgan Stanley Children's Hospital and NewYork-Presbyterian Komansky Children's Hospital have built national reputations for outstanding care devoted to children. 

The NewYork-Presbyterian Center for Liver Disease and Transplantation provides the most advanced, safe, and proven treatments for liver disorders in children of all ages. The NewYork-Presbyterian Center for Liver Disease and Transplantation has a history of close collaboration among clinical specialists, including hepatologists (liver experts), gastroenterologists, hepatobiliary surgeons (liver surgeons), radiologists, pathology experts, advanced care nurses, physician assistants, pharmacy specialists, social workers, nutritionists, psychologists and transplant patient support staff. 

Because we are part of a world-class medical center, we have the ability to centralize care for our patients and connect our patients to providers in more than 100 specialties and subspecialties. When the time comes, we can provide the support patients and their families need to ensure a smooth transition from pediatric to adult care.

25 years

of pediatric liver transplant experience


1-year graft and patient survival rate*


pediatric transplant center in New York


pediatric transplant center in the Nation

(*Our 1-year graft and patient survival rate [SRTR data 1/5/2023]. National average is 93.12% and 95.52%, respectively.)

Get Care

Choose NewYork-Presbyterian for Pediatric Liver Transplant

Pediatric liver transplant surgery is a life-altering procedure for the child and the parents. NewYork-Presbyterian is here to provide your family quality, comprehensive, compassionate care. 

To learn more about our pediatric liver transplant program and liver transplant options for your child, reach out to us for an appointment.