Pediatric Liver Transplant Treatments and Options

The liver is a vital organ in the body, one we can’t live without. A liver transplant replaces your child’s diseased liver with a healthy liver. Liver transplant is the best option when other treatments stop working. Over the past five years, biliary atresia, metabolic liver disease, liver cirrhosis, acute liver failure, and hepatoblastoma account for more than 75% of transplants performed.

How our process works

• We start by performing a thorough liver transplant evaluation (see the “FAQ for Patients” for more details), where your family meets with a multidisciplinary team of experts led by a pediatric hepatologist (liver specialist) who specializes in liver transplant.
• Once transplant is deemed necessary, we place your child on the national transplant waiting list. Every step of the way, the transplant team prepares your child for transplant. We assign your child a dedicated transplant coordinator, who helps guide you through the transplant process. Once a liver match becomes available, our highly skilled liver transplant surgeons perform the transplant. We then put in motion innovative techniques to help your child’s body accept his or her new liver, teach you how to support your child, and partner with your local specialists. Our care is lifelong, which helps to account for our transplant center’s impressive survival rates.

Pediatric liver transplant treatment options

By offering several types of transplants beyond the traditional whole liver transplant, we increase the pool of donor organs available, advocate with the review board to move your child up the list, and bring your child to transplant quickly to create the best possible outcome for your child.

Types of pediatric liver transplants

• Deceased: A whole or portion of a liver from a recently deceased child or adult is placed in your child.
• Full graft liver: Also called a whole liver transplant, the entire liver from a deceased donor is placed in your child.
• Split liver: A large liver is split and shared between your child and another child or small adult who is also awaiting transplant.
• Living donor: A portion of a living adult donor’s liver is transplanted in your child, with both growing a full liver within weeks.
• Reduced-size liver: A liver from a larger donor is trimmed to fit in your child.
• ABO incompatible: In this innovative transplant, your child’s blood type doesn’t need to fully match that of the donor, helping us move your child up the list so that a lifesaving transplant can be performed quickly.
• Combined solid organ: Also called multiorgan transplant; a liver is transplanted along with another organ such as the heart, lung, and/or kidney in critically ill children with complex needs.

Pediatric ABO incompatible liver transplant

We are proud to be a national leader in performing successful ABOi liver transplants.

Finding a matching liver donor can be difficult. You’ve likely heard about long waiting lists for donor organs. This innovative technique closes the gap between the number of donor organs available and the number of children who need them, saving lives.

In recent years, great progress has been made with ABO incompatible (ABOi) liver transplants. Today, rejection is limited by using current techniques and medications to suppress your child’s immune system so that it doesn’t see the new liver as foreign tissue.

ABO incompatible liver transplants make it possible for parents and family members who are not a full match to become donors.

Pediatric living donor liver transplant

Living donor liver transplant (LDLT) saves lives by expanding the number of organs available for transplant and shortening wait times. Our liver transplant program is one of a handful of transplant centers in the nation to offer adult-to-child living donor transplantation. We’re pleased to offer an innovative, leading-edge living donor option called 3-D laparoscopic hepatectomy. This minimally invasive procedure reduces operating time and may mean a faster recovery.

In this procedure, a healthy, living adult donates a portion of his or her liver to your critically ill child. In both the donor and the recipient, the remaining tissue grows into a fully functioning liver within six to eight weeks. Your child’s new liver will continue to grow throughout life.

Potential donors include parents, aunts, uncles, extended family, and even close family friends. Donors are tested for compatibility and need active insurance and a primary care physician. For more information about the living donor program, please contact the Living Donor Coordinator at (650) 724-5672 or visit Stanford Health Care’s Living Donor page.

Pediatric combined solid organ transplants

Lucile Packard Children’s Hospital Stanford is known for its high-performing Pediatric Transplant Center, which is a national pediatric organ transplant volume leader. We offer a full range of pediatric transplants, including liver, kidney, intestinal, heart, and lung transplants.

We’ve mastered multidisciplinary care, bringing pediatric specialists (cardiology, nephrology, pulmonology, etc.) and pediatric subspecialists (fetal cardiology, PACT, PICU, etc.) together to customize your child’s care team, with your family at the center. We work closely with all of the hospital’s transplant programs to provide combined solid organ transplants. We perform combined liver-kidney, liver-intestine, heart-liver, and liver-lung transplants as well as some rare heart-liver-kidney and heart-lung-kidney transplants.

There are several childhood diseases that require heart-liver transplants, including congenital heart disease. Lung-liver multiorgan transplants can be needed in children with cystic fibrosis, and liver-kidney transplants can be required for children with advanced metabolic kidney or liver disease. Children with intestinal failure requiring transplant sometimes also need a new liver.

While waiting for transplant, we set your child up for success by increasing his or her overall health with such methods as nutrition and dialysis, making sure that he or she is healthy and stable before transplant.