When is liver transplantation performed in children ?
The transplant is required when the liver is so badly and irreversibly damaged that only a new healthy liver offers any chance for the child’s long-term survival.It is also performed early when the replacing the liver removes the cause of the disease from the body.
What diseases damage the liver so severely ?
Some of the more common diseases are :
- Biliary Atresia : absence of development of the bile ducts that bring bile from liver to intestine
- Neonatal Hepatitis
- Progressive Familial Intra Hepatic Cholestasis ( PFIC )
- Acute Liver Failure ( ALF ), which needs Emergency Liver Transplantation
- Metabolic liver diseases :
- Wilson’s disease
- Glycogen Storage Diseases
- Hyperoxaluria ( needs Combined Liver & Kidney Transplant )
- Alpha-1-antitrypsin deficiency
- Crigler Najjar Type II
- Liver Tumours : Hepatoblastoma
- Congenital Hepatic Fibrosis
- Caroli’s disease
Where do donor livers come from?
There are two sources: living donors and recently deceased donors – as for adults. : deceased or living.
More often than not, we find that parents or relatives come forward to donate a part of their livers to children needing transplants. Live Donor Liver Transplant in children involves donation of only a smaller part of the left side of the liver .
What is the postoperative period like for the child?
The length of hospitalization will vary, depending on the individual patient. A typical hospital stay for school-age children is 14 to 18 days.
Patients are placed on immunosuppressive drugs to prevent rejection of the transplanted liver.. Since patients on immunosuppression are vulnerable to bacterial and viral disease, patients are monitored for signs and symptoms of infection.
The transplant team also monitors the child for signs of bleeding and other potential postoperative complications. Rarely, a patient will have to return to the operating room for evaluation and treatment of a postoperative complication.
Once the child leaves the hospital, what happens?
Initially, the patient visits the clinic twice a week for blood tests and clinical examination. As recovery progresses, these visits become less frequent. Our team will continue to be a part of follow-up care even after the child returns home.
What kind of evaluation is needed to determine whether a child needs a transplant ?
The child undergoes a multidisciplinary pretransplant evaluation to determine the current status of the liver disease. The child is seen by –
- Transplant pediatrician
- Transplant Hepatologist
- Transplant Surgeon
- Child psychologist
After their assessments of the child’s clinical status and all reports , our team of experts meets with the family and discusses all treatment options.