Pediatric Liver Transplant Surgery at Phoenix Children's Hospital
A liver transplant surgery is a complex process that requires the coordination of a large team of experts.
The majority of livers that are transplanted come from organ donors who have died. Deceased organ donors are adults or children who have become critically ill (often due to an accidental injury) and will not live as a result of their illness. If the deceased donor is an adult, they may have agreed to be an organ donor before becoming ill or their next of kin has decided to donate their organs to help others.
A child receiving a deceased donor liver transplant may either get a whole liver, or part of one. If an adult liver is available and is an appropriate match for two people on the waiting list, the deceased donor liver can be divided into two sections and each part is transplanted.
Living liver donors are another option for children in need of a transplant. Family members or friends may be able to donate a section of their healthy liver. This type of transplant is called a living donor liver transplant. Children who receive a living donor liver transplant do as well as those who receive a whole organ liver transplant.
A benefit of having a living donor transplant is that the surgery can be scheduled for a specific date, and before your child's condition may progress. The organ will also spend less time outside of the body (cold ischemia time) with a living donor.
Living liver donor surgery:
During the donor surgery, a portion of the liver is removed; usually the left lateral segment or left lobe. This surgically removed portion of the liver, as well as the remaining portion of the donor's liver, regenerates itself after the surgery. Typically, liver donors fully recover within three months and experience few complications.
Recipient liver transplant surgery:
After the child is prepped for surgery, they are put under general anesthesia. An incision is made in the abdomen and the child’s entire liver is removed. Once the new liver is placed in the abdomen, many new connections need to be reestablished, including the artery and vein that feed the liver, the vein that drains the liver, and the biliary system. There are many surgical variations that may be used depending on the donor and recipient's anatomy, in your child's liver transplant operation.
Most implanted livers immediately begin to create proteins such as clotting factors, maintain a normal metabolism and produce and drain bile from the liver.
After surgery, your child will recover in the ICU, under close observation. Recovery times vary, but generally children spend approximately two weeks in the hospital. During that time, your child will see the transplant team every day, and comprehensive blood tests and radiological tests will be obtained to ensure the new liver is functioning properly.