What are the most common childhood liver diseases?
Of patients with a serious pediatric liver diseases the most common include:

• Biliary atresia, which is the most common indication for liver transplantation in children.
• Intrahepatic cholestasis, this heterogeneous group of diseases includes neonatal infections, defects in bile formation and transport, and structural abnormalities of the bile ducts.
• Metabolic liver disease, metabolic and genetic liver diseases lead to considerable morbidity and account for approximately 30% of liver transplantations performed in children.
• Viral hepatitis, infection with the hepatitis A, B, and C viruses is now recognized as a major public health issue in childhood.
• Fulminant hepatic failure in children, fulminant hepatic failure is a devastating disorder to the family and child.
• Immune diseases of the liver and biliary tract. Autoimmune diseases of the liver, primarily autoimmune hepatitis and primary sclerosing cholangitis, are the most common serious liver diseases in adolescents in the United States and frequently progress to end-stage disease and the need for liver transplantation.

What kinds of treatments are available for my child?
Many young patients benefit from medications to manage their liver disease. For patients with viral hepatitis, antiviral medications can keep the disease at bay. For patients with high blood pressure in the arteries to their liver, surgery is an option to relieve excess pressure. For liver cancer patients, a range of surgery, radiation and chemotherapy options are available.

We offer advanced treatments and access to the most promising research studies when appropriate. Our goal is to give each patient the therapy they need, with the best chance of success. Our services include:

• Thorough evaluation using the latest technologies
• Access to latest antiviral medications to manage hepatitis patients
• Pediatric liver transplant
• Organ transplants and living donor transplants
• On-site testing of living donors
• Coordination with United Network of Organ Sharing registries to locate donor organs
• Access to clinical research trials
• Intensive monitoring following treatment
• Coordination with specialists to manage complications

When is liver transplantation an option for my child?
For many young patients with end-stage liver disease, transplantation is an option. The decision to transplant is based on the patient’s medical condition and quality of life.

How long will my child wait for a liver transplant?
The waiting time for a donor liver is 18-24 months. The actual waiting time depends on the number of people on the transplant list and the suitability of available organs. Young patients can have their name placed on the liver transplant list, but for some, a living-donor liver is an option.

What are my child’s living-donor transplant options?
Living donor liver transplantation is another option for young patients who need a liver transplant. In this kind of transplant, a healthy person (family member or friend) donates a portion of their liver to your child.

Doctors remove a single lobe of the donor’s liver, remove your child’s damaged liver and attach the healthy liver lobe in its place, where it begins to regenerate healthy tissue. The donor’s liver quickly regenerates, too, and continues to function normally. Both procedures are performed at the same time in two different operating rooms.

What are the advantages of living donor liver transplants for my child?
This kind of surgery can be scheduled, and can be performed before your child becomes extremely ill. This leads to fewer complications, faster recovery and better long-term results. This is a very safe procedure for donors.

What is the success rate of liver transplants?
Nationwide, liver transplants are effective about 85% of the time, whether a donor organ or living donor is used.

What can we expect during my child’s liver transplant?
Evaluation — Your child undergo a series of tests to determine if they are a candidate for liver transplantation.

• Donor — The transplant program coordinates with the local and national transplant lists to find a donor organ. Organ allocation is based on medical urgency, time on the waiting list and blood type compatibility. Living donors also must undergo evaluation, and must have compatible blood types.
• Surgery — The transplant surgeon removes the donor organ (or portion of healthy liver for a living donor), removes your child’s damaged liver and then attaches the donor liver. Recovery — Most young liver recipients spend several weeks in the hospital; living liver donors spend about one week in the hospital. Doctors monitor liver recipients closely for signs of organ rejection, infection or other complications.

How do you prevent organ rejection in my child?
Fortunately, a number of very effective medications are available to prevent organ rejection. These medications suppress the immune system, which inhibits rejection of foreign tissue. After a liver transplant, recipients must take medications daily for the rest of their lives.