Pediatric Liver Transplant – Liver Transplant for Children – Apollo Hospitals

PEDIATRIC
LIVER TRANSPLANTS
info@apolloinformationcentre.com

Pediatric Liver Transplants
Pediatric liver transplant is surgery that is performed to remove
a diseased liver in order to replace it with a healthy one. It is very
successful in treating children with liver diseases that cannot be
treated with routine medications and surgeries and offering them an
opportunity to live a long and healthy life.
Who is a candidate for a Liver Transplant?
Children who suffer from end-stage liver disease due to various
causes and when the likelihood of surviving without transplant is less
than surviving with transplant, the child may be considered for liver
transplantation. The most common indication in children is biliary
atresia. Biliary atresia is a rare condition in newborn infants in which the
common bile duct between the liver and the small intestine is blocked
or absent. Bile ducts, which are tubes that carry bile out of the liver,
are missing or damaged in this disease, and obstructed bile causes
cirrhosis. Bile helps digest food. If unrecognized, the condition leads to
liver failure. The cause of the condition is unknown. The only effective
treatments are certain surgeries, or liver transplantation. Other causes
of liver transplant can be autoimmune hepatitis (chronic liver damage
due to attack of body’s own immune system), viral hepatitis (chronic
viral infection causing inflammation of the liver), primary sclerosing
cholangitis (chronic condition in which tubes connecting the liver
become narrowed, blocked, and scarred), and tumors of the liver.
How is it decided that my child needs a Liver Transplant?
Eligibility is determined by a comprehensive medical evaluation by the
transplant team.
Pre-transplant evaluation process:
This consists of checking all the body systems with regards to
optimal function and presence of unexpected disease. Your child’s
immunization records will be reviewed. Following transplantation, some
vaccines cannot be given and others may not be as effective.
A detailed nutritional assessment will also be performed. Several tests
will be performed:
• Laboratory blood and urine tests
• Electrocardiogram (ECG)
• Chest X-ray
• CT scan of the liver and blood vessels
How long will the surgery take?
A typical liver transplant can last from 8-12 hours. The surgery for the
donor lasts approximately 5-6 hours. During the operation, surgeons
will remove the child’s liver and will replace it with the donor liver. The
surgeon will disconnect the diseased liver from the bile ducts and blood
vessels before removing it. The blood that flows into the liver will be
blocked or sent through a machine to return to the rest of the body. The
surgeon will put the healthy liver in place and reconnect it to the bile
ducts and blood vessels. Your child’s blood will then flow into your new

liver. Because a transplant operation
is a major procedure, surgeons will
need to place several tubes in the
body. These tubes are necessary
to help the body carry out certain
functions during the operation and
for a few days afterward.
What are the risks of
transplant surgery?
There are risks with transplant
surgery just as with any major
surgery. Some immediate
complications can include
bleeding and blood clotting
problems, respiratory problems and
malfunction of the donor liver. Longterm
complications include rejection
(when the child’s immune system
does not accept the new liver) and
infection. Fortunately, most of these
complications are treatable.
What is the postoperative
period like for the child
who undergoes Liver
Transplantation?
After your child’s surgery, he/she will be taken to transplant ICU where
he/she will stay for a week. After your child is transferred out of ICU to
the pediatric floor, the length of stay will depend on how quickly he/she
recovers. Average length of hospital stay is about 3 weeks.
What medications will my child take at home after
Transplant?

Your child will take 2 major types of medications in addition to
multivitamins and health supplements to prevent rejection. If your child
misses a dose, you need to contact our team. immediately.
Once my child leaves the hospital, what happens?
Initially your child has to come to the transplant clinic twice a week for
laboratory work up and physical examination or as frequently advised
by our team. As recovery progresses, these visits become less frequent.
Who will look after my child long-term?
Your child will be looked after by the primary pediatrician who will be
supported by our team.
What restrictions will my child have during her recovery?
For the first six weeks after surgery, your child should avoid strenuous
exercises.
When can my child return to school?
Your child should go back to school about 12 weeks’ post-discharge.
You have to meet ahead with the teacher to discuss your child’s
medical needs such as medication schedule, follow-up doctor
appointments, and possible effects of the medication taken by your
child like weight gain, facial changes etc.
What lifestyle changes are associated with Liver
Transplants?
Most patients
can return to
a normal or
near-normal
lifestyle six
months after
a successful
liver
transplant.
Recipients
should avoid
exposure to
people with
infections.
Maintaining a
balanced diet, and staying on prescribed medications are vital to stay
healthy. Children can attend school and participate in sports and other
age-appropriate activities and can have a normal married life in the
future with no fertility issues.
What is the survival rate for children with Liver Transplants?
Survival rate depends on several factors like age and health condition
of the child. However, our results are comparable to the most well
established centers from across the world.
Apollo Hospitals Center for Pediatric Liver Transplants
Apollo Hospitals, Navi Mumbai have a Comprehensive Liver Transplant

Program to provide the care and support the child and the family
needs. We have performed over 50 Pediatric Liver Transplants including
transplant in a youngest 4-months-old child. These transplants have
been successfully performed out at subsidized costs with a more than
90% success rate that compares with the best in the world.
Members of Liver Transplant Team:
Pediatric Hepatologists
These physicians take care of child before the transplant, after the
transplant (in coordination with the transplant surgeon), and also after
discharge from the hospital.
Transplant Surgeons
These physicians perform your child’s liver transplant operation and
oversee your child’s care in the hospital following the surgery
Anesthesiologists/Intensivists
These doctors administer anesthesia medicine to your child and
monitor him or her during the transplant surgery.
Transplant Coordinator
This person arranges your child’s care before and after transplant, helps
answer your questions, and provides support for you and your family.
Nutritionist
Many children with liver disease are not able to maintain normal weight.
Hence, a nutritionist would be monitoring the child’s diet and growth
before and after the transplant.
Medical Social Worker
Medical social worker helps patients and families with the pretransplant
waiting time, the hospital stay, discharge and care after your child
returns home.
Along the way, you will also meet many other people who will provide
care for your child and your family, including critical care physicians,
general pediatric nurses, and physical and occupational therapists.
Overall, these individuals will help you and your family get through this
stressful time.
For appointments:
- +254 748 830976/+254 789 150890
- info@apolloinformationcentre.com