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Children’s Healthcare of Atlanta is home to one of the largest pediatric liver transplant programs in the U.S., providing full pre- and post-transplant services for children who need a liver transplant. Combining the latest proven technology and research with a caring, child-friendly approach makes Children’s a top choice for your child’s liver transplant.

What is a liver transplant?

A liver transplant is a surgery in which doctors remove a sick liver and replace it with a healthy donor liver. The liver may come from a deceased organ donor or from a living donor who is willing to donate part of his or her liver and is a suitable candidate.

There are different types of liver transplants, including:

  • Auxiliary transplant: This is a transplant that places part of a healthy deceased or living donor liver next to your child’s liver. The healthy liver is connected to vital blood vessels and organs. It helps do the work of your child’s liver until he is well. Sometimes, the healthy liver can be removed after your child’s liver begins to work again.
  • Partial graft: This is a transplant in which doctors cut down a donated liver to a smaller size and then give it to your child.
  • Split liver transplant: This is a transplant in which a deceased donor liver is cut into two parts. The larger part is given to an adult or larger child, and the smaller part is given to a small child or infant.

Where does a transplant liver come from?

A liver transplant provides your child with a healthy liver from a donor. There are two main types of liver transplants:

  • A deceased donor transplant provides your child with a liver from a person who has recently died. This is the most common type of liver transplant. To receive a deceased donor liver, your child is placed on the United Network for Organ Sharing (UNOS) waitlist.
  • A living donor is a person who gives your child part of his or her liver. Since the liver is the only organ that can grow back, when doctors remove part of a living donor’s liver, the rest will grow back within a few weeks.

Why does someone need a liver transplant?

Children may need a liver transplant because they have severe liver problems or a disease that can lead to liver failure.

Conditions that may lead to liver failure include:

  • Acute liver failure
  • Alpha-1 antitrypsin deficiency
  • Ascites
  • Autoimmune hepatitis
  • Biliary atresia
  • Byler disease
  • Cirrhosis
  • Cystic fibrosis
  • Hemochromatosis/gestational alloimmune liver disease (GALD)
  • Hepatic encephalopathy
  • Hepatitis A, B and C
  • Intrahepatic cholestasis, I, II and III
  • Jaundice
  • Liver abscess
  • Liver cancer
  • Nonalcoholic fatty liver disease
  • Portal hypertension
  • Primary biliary cirrhosis

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Before your child’s liver transplant

Before your child is approved to have a pediatric liver transplant, he will undergo a pre-transplant evaluation—a series of tests that may include a routine medical exam, blood tests, imaging tests, breathing tests and other evaluations. If your child meets all of the standards from the pre-transplant evaluation and the child, family and liver transplant team decide a liver transplant is the best option, the next step is to place your child’s name on the United Network for Organ Sharing (UNOS) waitlist.

During your child’s liver transplant

After a donor is identified, your child’s liver transplant will be scheduled. During surgery, a pediatric liver transplant surgeon will first operate on the living donor, removing the portion of the liver that will be donated to your child. Then, the surgeon will remove your child’s diseased liver and place the donated portion of the liver in your child’s body. The surgeon will then connect your child’s blood vessels and bile ducts to the donated liver.

After your child’s liver transplant

Taking a child home after a transplant can be stressful. Your family may feel fear, anger, depression and guilt about the liver transplant. By sharing these feelings, you may find it easier to cope with change. Our team is here to help you in any way that we can.

  • Talking to your child about his liver transplant
    • Many children believe a liver transplant is caused by something they did, said or thought. Explain to your child that the cause of the liver transplant was not his fault.
    • Talk to your child about his feelings. Let him know that his feelings are normal. Be honest with your child about your feelings.
  • Medication after a liver transplant
    • After a liver transplant, your child will take important medicines called immunosuppressants. They will help keep your child from rejecting his new liver and keep him in the best possible health.
  • Possible complications after a liver transplant
    • Some children who undergo a liver transplant have complications. Infection and rejection are two of the most common complications after a pediatric liver transplant. Your child’s liver transplant team will help you learn about the early signs of liver transplant complications.
    • Rejection is a natural response of your child’s immune system. The immune system is the body’s defense against an “unknown” material, such as viruses, bacteria and some types of cancers. Your child’s body may try to reject the new liver because it recognizes it as an unknown in the body.
    • Your child is more likely to get an infection when taking immunosuppressants. The risk of infection is greatest in the first three to six months after a liver transplant.

Led by Joseph F. Magliocca, MD, Surgical Director, and Rene Romero Jr., MD, Medical Director, the Children’s Liver Transplant Program is dedicated to caring for infants, children and young adults before, during and after a pediatric liver transplant. Our team includes the following pediatric hepatologists and liver transplant surgeons:

Liver transplant surgeons

Pediatric hepatologists

Pediatric nurse practitioners

  • Christine M. Rambo-Martin, CPNP
  • Sheetal Sethi, DNP