Reasons for Liver Transplant

Liver transplantation is the standard of care for children with end-stage liver disease – those who can no longer be treated by medication alone.

Diseases leading to liver transplant

Though many diseases affect the liver, not all liver diseases are treated with a transplant. Our evaluation process will help to decide whether or not your child's disease requires a liver transplant. Diseases that damage the liver and could lead to transplant include the following:

Chronic End-stage Liver Disease (60%)

  • Biliary Atresia
  • Autoimmune Hepatitis/Sclerosing Hepatitis/Overlap syndrome

Liver-specific genetic /metabolic diseases (25%)

  • Causing chronic liver injury/failure
    • Alpha-1-antitrypsin deficiency
    • Familial cholestatic syndromes eg PFIC1 2 or 3
    • Allagille syndrome
    • Cystic Fibrosis Liver Disease
    • Tyrosinemia
  • Metabolic defects expressed in the liver leading to other organ damage eg brain, kidney
    • Urea cycle disorders
    • OTC deficiency
    • MSUD
    • Hyperoxaluria
    • Crigler –Najjar Syndrome
    • Glycogen Storage disease

Acute Liver Failure (10%)

  • Indeterminate (non-A, non-B, non-C hepatitis)
  • Viral hepatitis
  • Hepatic Drug toxicity (acetomenophin, NSAID’s, many others)
  • Genetic /Metabolic diseases: Wilsons disease, fatty acid oxidation defects, some mitochondrial disorders
  • Autoimmune Hepatitis
  • Neonatal Hemochromatosis

Primary unresectable liver tumors (5%)

  • Hepatoblastoma
  • Embryonal sarcoma
  • Hemangioendothelioma
  • Hepatocellular Carcinoma

Types of liver transplant

Since 2000, nearly 350 patients have received new livers. Procedures include whole organ, reduced-liver, and split-liver transplants. All aspects of pre- and post- liver transplant care are provided in a state-of-the-art setting using the most advanced technology.

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.

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 were first 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 differences.

Whole-liver transplant

The first liver transplants, performed more than 50 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, such as split-liver, living-related and reduced liver transplants described above.