When Your Child Needs a Liver Transplant (page 2)
Being told that your child needs a liver transplant may leave you feeling scared, angry, or confused. You might not fully understand why your child needs a new organ or where the new organ will be coming from. Just thinking about the months ahead may fill you with dread and apprehension.
Fortunately, most liver transplants are successful. Many kids who undergo these procedures go on to live normal, healthy lives once they recover from surgery.
In the long term, kids will need to take medications to help prevent complications and have regular checkups to monitor their new liver function.
Causes of Liver Failure
The liver — a soft, triangular-shaped organ — is the body's largest solid organ. It lies next to the stomach on the right side of the abdomen. The liver has many functions, like cleansing the blood of toxins, producing bile (which helps to break down food during digestion), and storing energy in the form of a sugar. When the liver stops working as it should, a child can get very sick, and even die.
The liver might fail to work properly for many reasons. Among children, the most common reason for liver failure is biliary atresia. This happens when the liver's bile ducts (tubes that carry bile out of the liver) are missing or blocked. When bile can't leave the liver, it causes liver damage, or cirrhosis. The causes of biliary atresia are unknown. Some children who have it are born with it; others develop it later.
Other reasons the liver might stop working include:
- alagille syndrome: an inherited (genetic) disease that causes liver abnormalities and other problems
- alpha-1-antitrypsin deficiency: an inherited disorder that prevents the body from producing the protein alpha-1-antitrypsin, leading to lung and liver damage
- hemochromatosis: an inherited disease that causes the body to take in and store too much iron, which can damage many organs
- hepatitis: liver inflammation that can have a variety of causes
- Wilson disease: an inherited disorder that causes a build-up of copper in the body, which can damage many organs
- acute liver failure: a condition in which the liver suddenly stops working, sometimes the result of a taking a medication or getting a virus
Getting a Healthy Liver
Doctors should only recommend getting a liver transplant after they have exhausted all other treatments for trying to save a child's liver.
During transplant surgery, the sick liver is removed and replaced with a healthy liver (or just part of a liver) donated from another person. Most organ donors are adults and children who have agreed (or their guardians have agreed) to donate their organs in the event of an untimely death. They choose to donate their organs because they want to help someone else who is sick.
If a child doesn't need a whole new liver, sometimes a portion of a liver can be donated from a living person, like a parent. This is called a "living-related donor transplant." A person who donates part of his or her liver can have a normal-sized liver again within just a few weeks of donating the tissue because livers are organs that grow new cells on their own (called regeneration).
Likewise, a child who receives a portion of a new liver will regenerate enough liver tissue to have a normal-sized liver within a few weeks of transplantation.
Determining When Surgery Is Needed
If your doctor thinks your child might benefit from a liver transplant, you'll be referred to a transplant center. There, a team of surgeons, liver specialists (hepatologists), a transplant coordinator, nurses, nutritionists, psychologists, and social workers will evaluate your child to determine whether he or she is a good candidate for the procedure.
The evaluation will include a medical history, a physical examination, and some tests, including blood tests and imaging tests (such as an abdominal ultrasound or CT scan). To check the liver more closely, the doctors also might perform a biopsy (in which a sample of the liver is removed to be examined under a microscope).
During the evaluation, the transplant team will try to find out as much information about your child as possible. This is also a time for you and your child to learn about transplant surgery. The transplant team is there to provide information and support. Be sure to ask them questions if you don't understand something.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation. All rights reserved.
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