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TEXAS CHILDREN'S LIVER CENTER
 Liver transplants

Liver transplantation is the standard of care for children with end-stage liver disease – those who can no longer be treated by medication alone. End-stage liver disease is characterized by fatigue, jaundice, impaired blood clotting, muscle wasting, hepatic encephalopathy and portal hypertension.

Reasons for pediatric liver transplants
In young children, the most common liver disease leading to transplantation is biliary atresia. Biliary atresia accounts for at least 50 percent of all liver transplants in children and is characterized by the failure of the bile ducts to develop normally and drain bile from the liver.

Liver transplants performed
at Texas Children's Liver Center
2008 26
2007 13
2006 16
2005 17
2004 20
2003 13
2002 10
2001 18
2000 12
1999 8
1998 4

Metabolic liver diseases that may or may not result in cirrhosis (scarring of the liver) – such as ornithine transcarbamylase deficiency, alpha-1 antitrypsin and Wilson Disease – also commonly result in a child’s need for a liver transplant.

Types of liver transplants performed at Texas Children's Liver Center

Split-liver transplants
In-situ splitting of the liver – dividing a cadaver’s liver while it still is in the donor’s body with the blood flowing to it – has emerged as the procedure with the greatest potential to increase the number of available livers. This method doubles the number of recipients who can receive transplants from a single liver.

Diagnoses leading to liver transplants at Texas Children's Liver Center

Biliary atresia

35 percent

Metabolic

23 percent

Other cholestatic

15 percent

FHF

11 percent

Miscellaneous

11 percent

HCV

  6 percent

Tumor

  3 percent

Drug

  0 percent 

Houston’s first in-situ split-liver transplant was performed in 1999 by Dr. John Goss, Texas Children’s Liver Center surgical director and associate director of Liver Transplant Surgery at Baylor College of Medicine; and Dr. Philip Seu, director of the Liver Transplant Program at Baylor College of Medicine. Drs. Goss and Seu are leaders in this technique.

Living-related donor transplant
In living-related donor transplantation, a portion of an adult relative’s liver is removed and given to a child recipient. This type of transplantation virtually eliminates delays for a transplant because the child does not have to wait for a cadaver donor organ.

Reduced-liver transplant
Reduced-liver transplants first were performed in 1984. With this technique, surgeons take a portion of a cadaver’s liver and place it in a child. Children have better chances of receiving livers because reduced-liver transplants can compensate for dramatic differences in patient and donor weight ratios.

Whole-liver transplant
The first liver transplants, performed more than 30 years ago, were whole-liver transplants. As the name implies, this type of transplant requires the procurement of a whole, healthy donor liver. However, the shortage of whole pediatric livers forced transplant surgeons to develop more innovative methods of transplantation.

For more information about pediatric liver transplants, please contact a liver transplant coordinator at 832-824-2575.