Keeping the Liver Healthy After Transplant
After your child receives a new liver, the next step requires a lifetime commitment from both the caretaker and the patient. Although your transplant team at Lurie Children’s will continue to provide you with support and education, it's up to you to follow their advice and provide them with your expertise and observations as a parent or caretaker.
Whenever possible, all required immunizations such as MMR (measles, mumps and rubella), and varicella should be given before transplant. After the transplant, your child should not receive any routine immunizations until approval is given by the transplant team (usually about six months after transplant). Modified immunizations will then be given according to the usual well-child schedule. Infants and children who are immunosuppressed, as well as all family members, should receive the inactivated polio vaccine (IPV). However, family members can receive the MMR.
An injection called VZIG is always given as soon as possible after your child has been exposed to chicken pox to prevent infection with the virus. Call the transplant team if your child has been exposed to chicken pox.
Cleanliness After Transplant
The most important guard against germs and infection for your child is consistent hand washing for all family members. You should avoid direct contact with people you know to be sick with colds or flu. Keep cuts and scratches, and any open areas in the skin, clean and dry. Inspect them regularly for any signs of infection, and notify the transplant coordinator if any changes occur.
While you may visit the transplant team often, it is also important to follow up with your pediatrician to monitor your child's growth and development, get immunizations and help you with any problems not related to her liver (for example, an ear infection). It is important that your pediatrician is aware that your child has had a liver transplant and what medications she is taking. A summary letter is sent to your pediatrician after discharge from the hospital and after each visit.
Regular dental check-ups are important to prevent infection, but should be avoided for the first six months after transplant when the child is taking the highest amount of immunosuppressant medications. Antibiotics need not be taken before a dental visit. Your child may also need to see a dentist due to swelling of the gums or bleeding as a result of cyclosporine therapy.
After transplant, the medications prescribed will cause sun sensitivity and put your child at higher risk for skin cancer. It is important to always apply sun screen when outdoors and to check your child's skin for irregular moles or growths.
Hearing & Vision Evaluations
We strongly recommend a yearly hearing test and a vision exam by an ophthalmologist for those who are on Prednisone. Also, some of the medications that your child receives during transplant can increase the risk for hearing loss.
School is an important part of your child's life. The transplant team encourages children to return to school as soon as possible following transplant (about three months). While recovering in the hospital and at home, a tutor may help your child keep up with their studies. It is important for others to understand that once your child has received a new liver, they’re no longer ill, but needs to continue to take medications and be followed by the transplant team. Please contact the transplant team should your child be exposed to any communicable diseases.
If you have any questions, please don’t hesitate to contact the transplant team.