Transplant of Liver — An Overview of its Importance for a Child

A liver transplant is usually a life-saving, the last course of treatment recommended by doctors after all other plans have failed. This procedure is important for children who experience acute liver failure and may die if they do not get a new liver.

There are approximately 500 children every year who get enlisted in the list of liver transplantation. Their age range spans anywhere from 11 years and older. Only a handful of successful transplants have been reported in the country. The number of pediatric liver transplants increased to 613 in 2008 from 573 in 2016.

Child Liver transplant

It is a surgery that replaces the child’s malfunctioning liver with another healthy one from another person. The organ can come from a deceased person. It can also come from a willing donor from the family who donates a part of their liver to the child.

However, most of the transplantation liver come from deceased organ donors. Medscape reports around 90% of transplants from deceased donors.

If the donor is an adult, he has to provide written consent to give the organ beforehand. Donors can cover parents too.

Types of liver transplants for children

A child may get an entire liver or a part of it. Let’s examine the two scenarios.

1 — If the adult donor’s liver is a match for two children, it can be divided into parts, and each part will be transplanted. This technique is known as a split liver transplant.

2 — If a living family member donates a liver to the child — it is known as the transplant of a living donor. The ones who give a part of their livers can continue to lead a healthy life. The rest of the operated organ will find its size back to the normal size after some time. It is interesting to note that the liver is the only visceral organ in a living being that possesses this capability to regrow and regenerate.

Children and liver transplant

One or more conditions may necessitate a child to undergo a liver transplant. These conditions will impair the proper functioning of the liver and hence cause a life-threatening situation if not treated on time. Some of these conditions include -

· Biliary atresia — In this, the bile ducts are scarred and blocked. This issue leads to bile build-up in the liver, instead of getting flushed with the wastes, thus deteriorating its performance. This problem is the most common reason for liver transplant in children.

· Alagille syndrome — This is a genetic disorder that often shows up in children. It happens when the bile ducts become narrow, thus hampering its flow from the liver to the intestines.

· Primary sclerosing cholangitis — The bile duct gets narrow because of scarring and inflammation.

· Hepatoblastoma — This is a very rare disease of the liver. It is a tumor that can spread to the other parts of the body.

· Acute liver failure — A sudden loss of liver function can cause failure. This issue happens when the organ gets damaged by some medication or virus.

There are other conditions like viral hepatitis or an antenatal condition, which can cause an issue with proper liver functioning and lead to a liver transplant.

Now that we know the basics of the condition leading up to the surgery let us focus on a few critical aspects of the operation itself.

Before the liver transplant surgery

If your child needs a liver transplant surgery, you can contact liver transplant support groups online, and they will help you get in touch with a transplant center. There you will be introduced with a team of healthcare experts including:

· Psychologists

· Surgeons

· Social workers

· Dietitians

· Liver specialists

This healthcare team will plan the entire procedure from the first to last. The team will go for tests like imaging tests and blood tests to verify the extent of damage to the liver. There can be a requirement of biopsy as well, where liver tissues are examined under a microscope. This way, the team will verify if your child needs the transplant or not.

The very next engagement is to search for a person who can become a donor. Your child’s name will be put up in the organ waiting list. The evaluation of the living donor will happen when a donor shows interest. Also, your child has to get a person who is a good match as a donor, so it can take a long time.

Risks of child liver transplant

There are some possible risks related to child liver transplant operation, and that can be,

· Excessive internal bleeding

· Rejection of the new liver

· Threat of infection

· Leakage of blocked ducts of bile

· The new liver not working after the surgery

· Blood vessels can get blocked.

Rejection of the new liver is a normal thing by the immune system of the body. When the new organ is transplanted, the child’s immune system regards it as a threat. For this, anti-rejection medicine is prescribed by doctors before the operation. They have to keep consuming this medicine, as suggested by the surgical team.

Recovery after the liver transplant surgery

The recovery part takes time. It will range from 10 to 14 weeks. Your child has to stay at the PICU (Paediatric intensive care unit) just after the surgery. The doctors and nurses will ask you to wait until they get your child settled. Here, your kid will be hooked up with different equipment to monitor vital signs and aid the recovery process.

If you have a child who needs a liver transplant surgery, you can always contact some leading crowdfunding platforms, and they will help with the doctors and donor facilities as well. Such an avenue is much preferred by families who aren’t economically well-off to afford decent quality healthcare for the small kid stricken with liver failure.