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.

Some of the more common ones are:

Congenital abnormalities

• Extrahepatic biliary atresia
• Sclerosing cholangitis

Metabolic liver disease

• Alpha-1-antitrypsin deficiency
• Wilson’s Disease
• Tyrosinemia
• Glycogen storage diseases
• Hyperoxaluria
• Crigler-Najjar type II
• Hyperammonemic syndromes

Acute hepatic necrosis (death of liver tissue) due to:

• Toxins
• Drugs
• Viral infections
• Unknown causes

Cirrhosis – a chronic problem that impairs the liver’s ability to remove toxins (poisonous substances) from the body

• Autoimmune – cirrhosis resulting from the body’s own immune system attacking the liver
• Cryptogenic – cirrhosis that has an uncertain cause

Cholestatic liver disease

Liver tumors, both malignant and benign (noncancerous)

Other diseases and conditions

Congenital hepatic fibrosis

• Caroli Disease
• Cystic fibrosis

Before final selection and listing for liver transplantation, the child undergoes a multidisciplinary pretransplant evaluation to determine the current status of the liver disease and the extent of its progression. All outside medical records, radiological studies, and liver biopsy materials are reviewed. The transplant hepatologist, and surgeons do consultations. Blood tests may include

• Chemistry panel
• Liver panel
• Hematology group
• Coagulation studies
• Blood typing and antibody screen
• Infectious diseases: hepatitis serologies, HIV, cytomegalovirus

Imaging studies and other tests

• Ultrasound of the liver
• Liver biopsy (optional)

After these assessments and tests are completed, our team of experts meets with the family and discusses all treatment options.

There are two sources: living donors and recently deceased donors.

Deceased donors are individuals whose organs have been made available for donation at their own request before death or by their families after death. The types of deceased-donor transplants include:

Full graft liver transplantation – The entire liver from a deceased donor is transplanted to a recipient of similar body size.

Reduced-size liver transplantation – A liver from a larger donor is trimmed to fit a smaller recipient.

Split liver transplantation – A large liver is split and shared between a small adult (right lobe) and a child (left lobe).

Unfortunately deceased donor organs are available only rarely in the Indian subcontinent and across most of Asia.

For more information on living donor click here (should link to the section of live donor living transplant under transplant operation)

One of the advantages of living-donor transplantation is that the procedure can be scheduled at a time that works best for both donor and recipient. For the donor, the major issue is his or her work and family schedule. For the recipient, the principal constraint is health condition and control of complications. For example, if the recipient develops a sudden fever, the procedure will be delayed until the cause is found and any potential infection controlled.

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 immunosuppressant are vulnerable to bacterial and viral disease, they 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.

Initially, the patient visits the Clinic twice a week for laboratory work and physician examinations. As recovery progresses, these visits become less frequent. Our team will continue to be a part of follow-up care even after the patient is able to return home.