Liver Transplant in Children

Surgery Overview

A liver transplant is surgery to give your child a healthy liver from another person. Your child may get a whole new liver or just part of one. It may come from a live donor or a person who is deceased. If your child gets a part of a liver from a live donor, the parts will grow back to full size in your child and in the donor.

Your child's doctor or a transplant center will do tests to see if a transplant will work well for your child. This will depend on things like your child's age, weight, and whether there are certain risks, such as a medical condition. If tests show that a transplant is a good option for your child, your child will be put on a waiting list to receive new organs.

Choosing a transplant center

Your child's doctor can refer you to an organ transplant center. You can get information about different centers and talk with the doctor about your best option. When choosing a transplant center, consider things like cost and payment options, location and travel, family support, and what types of organ transplants are offered. Learn as much as you can about each center.

How It Is Done

To do the surgery, the doctor makes a cut (incision) in your child's upper belly. Then the doctor removes the liver. Next, the blood vessels of the new liver are connected to your child's blood vessels. The bile duct of the new liver is connected to your child's bile duct or intestine. The doctor finishes the surgery by closing the incision with stitches or staples. The stitches will dissolve inside your child's body. The staples will be removed a few weeks after surgery. The incision will leave a scar that will fade with time.

What to Expect

Your child will be cared for in the intensive care unit (ICU) for a couple of days after surgery. Then your child will probably spend 1 to 3 weeks in the hospital. Most children are able to go back to regular activities in about 2 to 3 months. But it depends on how your child feels. It may take 2 to 4 months for their energy to return.

After surgery, the new liver should start to do the work that your child's diseased liver could not.

After the transplant, your child will take medicine to keep their body from rejecting the new liver. Your child will most likely need to take anti-rejection medicine every day for the rest of their life. These medicines have side effects. One side effect is that the body may be less able to fight infections.

It's important to take steps to avoid infections from now on. Teach your child to be careful at school and around other people. Make sure that your child avoids anyone who might have an infection or an illness such as a cold or the flu. Call the doctor anytime your child has a fever.

Getting support

Having good support is important as your child follows the process of getting a transplant. Waiting for the transplant can be hard emotionally for you and your child. After the surgery, there may be concerns about your child's health and the new organ they received. There will also be a lot to manage, like taking new medicines and going to follow-up visits.

Getting support from others, such as friends and family, can help during this time. A counselor can help you and your child learn to cope with stress and other emotions before and after the surgery.

Many people who have an organ transplant feel anxious or depressed. Talk to your doctor if you think your child may be depressed. Depression can be treated with medicines and counseling.

Why It Is Done

Your child may need a transplant if their liver doesn't work as it should. This is often because of damage from blocked bile ducts, a genetic problem, or a tumor. A transplant may be needed because of sudden (acute) failure, such as from an overdose of acetaminophen (Tylenol).

How Well It Works

Most children can have a good quality of life after their transplant. The success of a liver transplant may depend on:

• Taking your child to all follow-up appointments, getting all their tests, and calling your doctor if your child has problems.
• Your child's overall health. After the transplant, it's important for your child to keep a healthy lifestyle. This includes eating healthy foods and being active.
• Whether your child takes medicines as prescribed. Most people take anti-rejection medicines every day for the rest of their lives.
• Finding and treating organ rejection early. This makes it more likely that the transplanted liver will stay healthy. That's why it's important to go to follow-up appointments and get tests.
• The disease that caused your child's liver to fail.

Risks

Like any surgery, a liver transplant has some risks. Risks include:

• Organ rejection. The body sees the new liver as foreign and tries to destroy it. This happens because the donor liver doesn't match the body's tissue exactly.
• Problems such as bleeding during and after the surgery.
• Infection. The medicines that help fight organ rejection can also make it harder for the body to fight infection.
• Certain cancers, such as skin cancer. This risk increases because anti-rejection medicines can also prevent the body from attacking cancer cells.