Once your insurance has approved your child's transplant, he or she will be placed on the transplant waiting list. You will receive:

• A letter stating that your child's name has been added to the list.
• A doctor’s order showing what lab tests your child will need at your local clinic. Bring this to the clinic. The order will state how often your child needs lab tests and where the clinic should send your child's results.

What is my child's MELD or PELD score? How does it affect his or her time on the waiting list?
MELD stands for Model for End-Stage Liver Disease. PELD stands for Pediatric End-Stage Liver Diease. The MELD score is used for liver patients ages 12 and older. It is based on bilirubin, the International Normalized Ratio (INR), and creatinine. PELD scores are given to liver transplant patients less than 12 years of age. The PELD score is based on bilirubin, INR, albumin, growth failure, and age of the child when he or she was listed for transplant. These scores calculate your child's risk of dying while  waiting for a transplant. 

MELD scores range from 6 to 40. PELD scores can range from a negative number to a very high number, such as 50. The patient with the highest score receives the next liver available for his or her blood type. The higher your child's score, the more often he or she will need lab tests. Your doctor or transplant coordinator will tell you what your child's MELD or PELD score is at each clinic visit.

Your child's lab results must be sent to the transplant office on time. (See below.) Make sure your clinic sends the results on time, or call your transplant coordinator after each lab test. If you do not, your child may fall to a very low PELD or MELD score. This means your child's transplant could be delayed. If you have questions, please talk to your child's coordinator.

Your child's MELD/PELD score will change over time. A member of the transplant team will tell you how often your child needs lab tests.

Your child's donor
Your child's new liver will be “matched” according to size and blood type. A liver is chosen from a donor who has the same blood type as the recipient. The new liver must fit into the body in about the same position as the original liver: the upper side of the abdomen, under the ribs. The blood vessels leading to and from the liver can be more easily connected if they are about the same size as those of the old liver.

There are three types of donors: deceased donors and living donors.

Deceased donors
A deceased donor is someone whose tissues or organs are donated soon after he or she dies. Some of these donors have livers that are large enough to split between two people. Split livers are used only in smaller recipients. If this is an option for your child, the surgeon will tell you during your child's evaluation.

The donor’s health history may affect the success of your child's transplant. If the organ is damaged before we receive it, this may affect your child's outcome as well. There is a very small risk of getting a disease from a deceased donor (such as HIV or hepatitis). All donors are tested for disease, but some diseases may not show up at the time of testing.

Living donors
The wait time for a deceased donor liver can be very long. At the University of Minnesota Amplatz Children's Hospital, it is sometimes possible to use a live donor. A living donor transplant involves taking part of the liver from a family member or friend and using it for transplant. We can do this because the liver is one of the few organs that can regenerate (grow back).

A living donor may help your child avoid a long wait for his or her new liver. The donor must undergo a major surgery that involves some risk. The donor must be in good health to qualify. A living donor is often a friend or family member. If someone you know is interested in being a living donor, he or she can contact the transplant office after your child's evaluation is completed. A donor needs to have a medical and psychological evaluation. If your child is very ill, a living donor may not be an option.

Click here to learn more about our Living Liver Donor Program.