Pediatric liver transplantation is a life-saving procedure for children with end-stage liver disease (ESLD) or acute liver failure when no other treatments are effective. Advances in surgical techniques (like split-liver and living-donor transplants) have significantly improved outcomes.
When is a Liver Transplant Needed in Children?
Common Causes:
1. Biliary Atresia (most common reason in infants) – Blocked bile ducts leading to liver damage.
2. Metabolic Disorders –
- Alpha-1 Antitrypsin Deficiency
- Wilson’s Disease (copper accumulation)
- Tyrosinemia
3. Acute Liver Failure – Sudden severe liver dysfunction (e.g., from viral hepatitis, toxins).
4. Liver Tumors – Rare (e.g., hepatoblastoma if unresectable).
5. Genetic Conditions – Alagille syndrome, progressive familial intrahepatic cholestasis (PFIC).
Symptoms Leading to Transplant Evaluation
A child may need a liver transplant if they have:
- Jaundice (yellow skin/eyes)
- Severe Itching (from bile buildup)
- Failure to Thrive (poor growth, malnutrition)
- Ascites (fluid in the abdomen)
- Easy Bruising/Bleeding (due to clotting issues)
- Hepatic Encephalopathy (confusion, seizures from toxin buildup)
- Recurrent Infections (weakened immune function)
Types of Pediatric Liver Transplants
- Deceased-Donor Transplant – Full or partial liver from a deceased donor.
- Living-Donor Transplant – A portion of a healthy adult’s liver (often a parent) is used.
- Split-Liver Transplant – A deceased donor’s liver is divided for two recipients.
- Auxiliary Transplant – Part of the liver is transplanted while leaving the native liver (used in some metabolic diseases).
