Understanding Pediatric Liver Transplants

What is a Pediatric Liver Transplant? 

A pediatric liver transplant is a surgical procedure that replaces a child's diseased or malfunctioning liver with a healthy one from a donor. It's a life-saving treatment for children with end-stage liver disease, offering them the chance to live a long and healthy life. 

Lurie Children’s has one of the largest and most experienced pediatric liver transplant surgery teams in the country. We provide family-centered care, which means the entire family is involved in the patient’s treatment plan. Learn more about the Liver Transplant Program. 

Pediatric Liver Transplant Criteria

Children with various liver conditions may be considered for a transplant. These conditions include:

• Acute Liver Failure: Sudden and severe liver damage causing life-threatening complications. 
• Chronic Liver Disease: Progressive liver damage over time, such as biliary atresia, cystic fibrosis or Alagille syndrome. 
• Liver Tumors: Inoperable or aggressive tumors such as hepatoblastoma. 

Not all children with these conditions qualify for a transplant. Specific criteria, such as the severity of their condition, overall health, and absence of other serious medical conditions, are evaluated by Lurie Children’s liver and transplantation experts. 

Types of Liver Transplants

• Whole Liver Transplant: Replacing the entire diseased liver with a whole donor liver.
• Split-Liver Transplant: Using a single donor liver for two recipients, typically an adult and a child.
• Living-Donor Liver Transplant: Receiving a portion of a liver from a living donor, usually a parent or close relative. 

Pediatric Liver Transplant Procedure

Before the Transplant 

Lurie Children’s medical and surgical teams will assess the child’s candidacy and compatibility with potential donors. Evaluation before the transplant is likely to include blood tests, imaging studies and other tests to understand the patient’s medical condition. The child and family will also undergo psychological evaluation to prepare for emotional challenges that may arise related to the transplant. 

During the Procedure

The child will receive general anesthesia from a pediatric anesthesiologist. The transplant surgeon will remove the diseased liver before the donor liver is prepared and implanted. The surgeon will then connect blood vessels and bile ducts to the new liver. This procedure typically last several hours, but Lurie Children’s team members update the family while the child remains in the operating room. 

After the Procedure

The patient will be monitored closely in the pediatric intensive care unit. The patient will remain in the hospital for several days. The patient will receive immunosuppressive medications to prevent the body from rejecting the new liver. Once the child can leave the hospital, they may need to remain in close proximity for several weeks or more to the hospital for frequent follow-up appointments. Long-term care following a liver transplant involves regular follow-up appointments and tests to monitor liver function and medication management. 

Risks and Complications

There are risks and complications that can be associated with a liver transplant. These include: 

• Rejection: The body's immune system attacking the new liver, requiring increased immunosuppression or even another transplant. 
• Infection: Increased risk due to immunosuppression. 
• Bleeding: During surgery or post-transplant due to other complications.  
• Bile duct complications: Leakage or blockage of the bile ducts draining the liver. 
• Vascular complications: Blockage or narrowing of blood vessels supplying the new liver. 

Symptoms of Rejection

• Fever
• Fatigue
• Jaundice (yellowing of the skin and eyes)
• Abdominal pain
• Dark urine
• Light-colored stools
• Decreased appetite

Lurie Children’s medical team will work together to help prevent, or if necessary, to treat any of these complications. 

Tips on Living after a Liver Transplant 

• Medication Adherence: Taking immunosuppressive medications regularly and as prescribed is crucial. 

• Healthy Lifestyle: Eating a balanced diet, exercising regularly and maintaining a healthy weight are essential. 

• Infection Prevention: Practicing good hygiene, avoiding sick individuals, and following vaccination schedules. This includes attending all scheduled appointments and tests to monitor progress and manage potential complications. 

• Emotional Support: Seeking support from family, friends or professional counselors to cope with the emotional challenges of transplant and chronic illness.