What you should know when your child needs a liver transplant?

What is a liver transplant?

In liver transplant surgery, a healthy liver from a donor replaces the damaged liver. It can be from the living donor were part of the liver from the donor is taken and placed in a patient or it can be deceased donor transplant in which a part or complete liver is placed inpatient from the brain dead donor.

 Why my child needs a transplant?

When all other treatment options fail and the liver is irreversibly damaged then a transplant is the only chance for the child’s long-term survival. 

What are the common diseases, which need a transplant in children?

The most common disease, which needs a liver transplant, is biliary atresia. Other diseases, which require a liver transplant in children, include Wilson’s disease, Alagille’s Syndrome, hepatitis, alpha-1-antitrypsin deficiency, and hemochromatosis.

What to do when a child is referred for Liver Transplant?

 Once it is decided that child needs a liver transplant, your will be referred to a transplant centre. Transplant team, which usually includes surgeons, pediatric liver specialist, transplant coordinator, dietitians and psychiatrist, will evaluate the child and donor to make sure that your child is healthy enough to have surgery.

Child and donor will be further evaluated by blood tests, imaging and if required biopsy. The transplant team will provide you with all the information and support needed before and after transplant. Simultaneously donor also will be evaluated.

While waiting for a transplant, the child should be kept healthy and fit with a special focus on nutrition. 

How the Liver Transplant Surgery is done?

In the operating room, the child is given anesthesia, which will continue throughout the operation. After giving cut on the belly damaged liver is removed. After taking part in the liver from the donor the new liver is placed. The cut, which was given in the belly, is closed by putting stitches.

Liver transplant surgery lasts between 8 to 15 hours. 

What next After Liver Transplant Surgery?

After surgery, the child is shifted to the pediatric intensive care unit. Stay in ICU will depend on his or her condition and recovery. After recovery, the child is shifted to the room. Most children stay in the hospital between two to three weeks after surgery. During this time, the family is trained for taking care of the child. At the time of discharge, instructions will be given to the family, which should be strictly followed.

What are the complications, which can happen after a transplant?

Most kids will not have any problems after the surgery but some may have. Commonest problem after liver transplant is rejection. Rejection happens when the immune system of the child tries to attack it. The risk of rejection is high in the immediate post-transplant period. 

It can be managed by immunosuppressants and other anti-rejection medicines. While taking Immunosuppressant medicines child will have a chance to get infections, especially in the early days after transplant. So cleanliness including frequent hand wash is very important. The child should be kept away from the sick population. 

 What will happen in the long term after the transplant?

Once recovered from liver transplants almost all children will live normal, healthy lives. It is important that your child takes all medicines under the supervision of the doctor. He or she should be encouraged to and encourage to do exercise regularly and should take healthy diet. Contact your doctor if you feel something abnormal or child have any abnormal symptom or sickness.  You should see the doctor to check-up regularly as advised by him or her. 

Can My Child live a normal life?

Yes after transplant child can go to school and can play games with friends like any other children. 

 

Dr Shailendra Lalwani

HOD And Consultant - Liver Transplantation And Hepato-Pancreatic Biliary Surgery

Manipal Hospitals, Dwarka, Delhi

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