What is Pediatric Liver Transplant?
What is Pediatric Liver Transplant?A pediatric liver transplant is a life-saving surgical procedure in which an end-stage diseased liver is replaced with a healthy one. When a condition or disease severely damages the liver or prevents it from functioning properly, a liver transplant may be necessary. Although the most common reason for a pediatric liver transplant is a rare and challenging disease called biliary atresia, there are many others.
A healthy liver may come from a recently deceased donor or, in some cases, a portion of a liver from a healthy living donor. The liver's regenerative ability allows for a portion of the living donor’s liver to be safely transplanted, with both the donor and recipient’s livers growing back to nearly full size within a few months. Parents are among the most common living donors for children needing liver transplants – donating in about 80% of cases. This is not only because parents are of course highly motivated, but also because they typically have a compatible blood type and meet the requirements for donation.
What We Treat
What We TreatOur liver specialists have extensive expertise in caring for children of all ages with liver conditions. Some of the most common liver diseases we treat are:
When the liver suddenly stops functioning within just a few days
An inherited liver disorder in which bile builds up in the liver and affects the liver, heart and other parts of the body
An inherited condition where the liver produces an abnormal form of the alpha-1 antitrypsin protein
Rare metabolic disorders that cause the accumulation of abnormal bile acids and other substances that can damage organ systems
This condition affects infants and prevents the liver from draining bile to the intestines
An inherited disease that causes mucus to build up throughout the body and can affect multiple organs
The abnormal growth of cells in liver tissue can cause cancer in the liver, with Hepatocellular carcinoma being the most common
Elevated blood pressure in the portal vein which is the major vein that carries blood to the liver
An infection that causes liver swelling and damage which several different viruses can cause
A genetic disorder that prevents the body from excreting copper, causing it to build up in tissue
How is a Pediatric Liver Transplant Performed?
ProcedureWe know how emotional and overwhelming it can be to go through such a vital procedure for your child’s health. Our transplant care team will be with you every step of the way to provide the information, support, and resources you need during this difficult time.
Here is the typical pediatric liver transplant process, which takes six to eight hours on average:
- Your child will receive general anesthesia right before the procedure is performed
- The transplant surgeon will make a small incision on the upper part of your child’s abdomen (belly) and the blood vessels and bile ducts leading to the diseased liver are carefully detached
- The diseased liver is removed, leaving portions of the major blood vessels in place
- A healthy donor liver, or portion of one, replaces the diseased liver
- The surgeon attaches the blood vessels and bile ducts to the new liver
- The incision is closed with surgical thread or medical glue
Risks to Consider
RisksA liver transplant is a life-saving operation, yet like many medical procedures, it is associated with some risks. a. We will discuss these potential risks with you and your family so you can make the best decisions for your child. It’s important to talk through these risks because they can lead to longer hospital stays, increased recovery time, and, rarely, death.
These risks include:
- Liver rejection by the body
- Infection
- Internal bleeding
- Bile leakage
- Wound healing issues
- Primary graft dysfunction when the liver doesn’t function after surgery
- Medication side effects
Preparing for Pediatric Liver Transplant
Preparing for Pediatric Liver TransplantWe work closely with you to ensure your child is prepared for surgery and that everyone involved feels comfortable. Before your child undergoes a pediatric liver transplant, we may need to conduct a few preparatory tests, such as:
- 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 SurgeryEvery child’s recovery from a liver transplant is different but we will be there to provide compassionate care and help manage any fear or discomfort your child may experience. The typical recovery process for most children after a pediatric liver transplant involves:
- A hospital stay of about 7 to 14 days, with infants needing a bit longer
- Close monitoring in the PICU (pediatric intensive care unit) by your child’s liver transplant team
- Encouraging mobility within days of surgery to help with recovery
- Careful review by our physician assistant and pharmacist of your child’s at-home medication plan
- The importance of your child taking immunosuppressants, most likely for the rest of their life
- Adaption of a healthy diet and exercise regime by your child, being careful to avoid activities initially that could harm the new liver
We’re here to guide and support you through every step of the journey.
Choose the Children's Hospital of New York for Pediatric Liver Transplant
Pediatric liver transplant surgery is a life-changing procedure for the child and the parents. The Children’s Hospital of New York is here to provide your family with 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.