Liver Transplant (Pediatric)

A liver transplant improves the length and quality of life of children whose own livers have failed. The Pediatric Liver Transplant Program at the University of Michigan is part of the first and largest liver transplant program in the state, and one of the original transplant centers in the country. Our dedicated, multidisciplinary pediatric team includes nutritionists to help children get the calories they need to diminish complications post transplant. Since 1986, we have performed more than 300 pediatric liver transplants.

There are a variety of reasons a child may require a liver transplant, including:

  • Biliary atresia
  • Autoimmune hepatitis
  • Inborn errors of metabolism (including argininosuccinic aciduria and tyrosinemia)
  • Acute liver failure

Nutrition therapy is a key component of the Pediatric Liver Transplant Program. Many children with liver diseases don’t grow like they’re supposed to, so getting them nutritionally stable will get them ready for transplant sooner and avoid complications following transplant. Formulas, vitamins and feeding tubes are some of the options our dedicated nutritionists use to get kids the nutrition they require.

What you should know about our dedicated Pediatric Liver Transplant Program

  • We provide individualized patient and family centered care provided by a team of specialized health care professionals.
  • We provide transplants for children of all ages from about 3 months to 18 years of age.
  • Education is provided before, during and after the transplant for children and their families, utilizing our Child Life services and Pediatric Transplant Psychologists, to ease anxiety, answer questions and help kids feel in control of their treatment plan.
  • We ensure each child and family are involved, collaborating members of our team, which includes social workers, dieticians, transplant coordinators, nurse practitioners, physicians, surgeons, living donor advocates, financial coordinators, pharmacists and clinical research team.
  • We offer options that can delay the need for a liver transplant and/or prolong life while waiting for a donor liver, including bioartificial liver devices, which replicate liver function outside the body to support select children with acute liver failure.
  • We have expertise in small infants and children with technically challenging concerns.
  • Approximately 15 pediatric liver transplants are performed each year.

The Transplant Process

Candidates for liver transplant require a comprehensive evaluation. The process includes education, medical records review, patient examination and often additional medical testing. The case is then reviewed by our multidisciplinary pediatric transplant team and a decision about the child’s suitability for an organ is made.

Since routine medical care must be current prior to transplantation, it’s recommended that children are current with their routine health care prior to their evaluations. Examples of routine health care include dental exams and cleaning, immunizations (including PPD, pneumovax, and influenza vaccine).

At the follow-up evaluation, the child and family meet with several members of the pediatric transplant team, including a transplant coordinator, hepatologists, surgeon, nutritionist, social worker and a nurse educator. The evaluation appointment involves a variety of tests, such as blood tests, chest x-ray and urinalysis. Each child must attend the patient education class on transplantation.

For liver transplant, multi-listing is available, allowing children to be listed at more than one center, usually in a different state, to improve chances of getting a donor liver. Children and their families must have the ability to travel, have the financial means and may have to go through the entire evaluation process at each center.

When a donor organ becomes available, the child and family head to the hospital. The liver is removed and the new liver is placed into position. Most liver transplants take four to six hours. Following the operation, the child goes to the recovery room for four hours and then to the hospital room (directly to the PICU and then to 12 East within 3- 5 days after surgery. Children may be discharged between seven to ten days after the procedures, depending on how smoothly they recover from the transplant surgery.

For children who get sick very quickly, we can evaluate on an emergency basis as an inpatient. And our Survival Flight air travel service allows us to transport children from all over the state, 24 hours a day.

Post-Transplant

Our team is dedicated to helping children become healthy, functioning adults. To ensure they are able to care for themselves as they get older and go on to live independent lives, we access each child carefully to determine their ability for self-care. We begin that transition process very early – before they are teenagers – so they can administer their own medications, call for their own prescriptions and more. It takes a lot of supervised transition education before most kids can provide their own self-care, so the earlier we start the process, the better their chances for success.

  • Children can typically return to school 6-8 weeks after transplantation.
  • A dedicated social worker will help kids with home schooling until they can go back to school full time.
  • Our Transplant Specialty Pharmacy has pharmacists and customer service staff specialized in transplant medications, dedicated solely to assisting our patients through their treatment process.
  • Each summer we provide children 7-15 years of age, who have had an organ transplant, an exciting camping experience called Camp Michitanki.

Transplant Research Studies

Research is an important component of the University of Michigan Transplant Center, where we are committed to cutting-edge studies that will benefit today's children and patients of the future. The Pediatric Liver Transplant Program has active research studies in a variety of areas, including sleep disorders in children with liver disease, which may explain why candidates for liver transplant are often poor performers in school. Our comprehensive multidisciplinary clinics and extensive clinical and basic science research programs assure our kids have access to the newest medications and technologies.

For more information, contact us at 877-543-7789.