A liver transplant is a surgical procedure which involves removal of the patient’s damaged liver and replace it with a whole or part of healthy donor liver. Liver transplantation surgery is suggested when a child’s liver has stopped working adequately, and it has become life-threatening. This condition is called liver failure. A liver transplant is done after other treatments have been tried and failed to save the child’s liver. The surgery requires an organ donor who can be adults and children. They can be either a person who has a healthy liver and body, and agreed (or their guardians have agreed) to donate their liver after they die. Organ donors can be a living person, such as a parent, who may donate part of a liver, if a child doesn’t need an entire new liver. This kind of operation is known as a living-related donor transplant. Liver transplant in Turkey has an excellent success rate and foreign patients can undergo the procedure if they have a living organ donor.
Why might my child need a liver transplant?
A liver transplant is typically recommended for children when they have a serious liver problem and will not survive without a new liver. Biliary atresia is the most common liver disease in children who need liver transplants. This is a rare disease that affects the liver and bile ducts in newborns. Other medical conditions that may need liver transplant treatment include:
- Liver cancer and other tumors of liver
- Acute liver failure that starts suddenly. It can be caused by an autoimmune disease, an overdose of medicine, such as acetaminophen, or unknown causes.
- Certain genetic or hereditary liver diseases
- Alpha-1 anti-trypsin, an inherited condition that increases the risk for liver disease and failure
- Cogenital conditions that are present since birth, including Alagille syndrome or cholestatic disorders
- Viral hepatitis infection
- Accumulation of too much iron in the body, a condition called as hemochromatosis. It can cause damage to organs.
Liver transplant: types of operation
Living-donor liver transplants: This type of liver transplantation has been very successful in children. The data suggests that the results of living-donor liver transplants are perhaps better than, and at least similar to, the deceased donor liver transplantation. The living-donor liver transplantation is based on the ability of the liver to regenrate and form the whole organ from a portion of liver. In this operation, a part of a healthy living person’s liver or a lobe is taken and transplanted into the patient or recipient. The part of the liver in the patient as well as donor grows back to its normal size. The surgery on the donor to obtain a portion of their liver and the surgery on the recipient to put the donated liver, are performed simultaneously. The donor can expect to stay in the hospital for around one week. The portion of liver in both the donor and the recipient will regenerate and form a normal size organ within two to three months.
Deceased-donor liver transplants: In many cases, the healthy liver may come from a person or donor who has just died. Mostly a whole liver is transplanted, but a part of the liver can also be used in some cases. In a split-liver transplantation, a deceased donor’s liver is dividing and transplanted into two recipients – normally a small child and an adolescent or adult. This type of transplantation can help two patients with one liver donation. Anothe surgery called reduced-liver transplant involves the use of a piece of a deceased donor liver for a smaller patient. These operations are possible due to the liver’s unique ability to regenerate and grow back to its normal size. There are not enough deceased donor livers to meet the rising demands of all potential recipients, therefore a living liver transplantation is the preferred treatment for many people with liver disease.
Tests before liver transplantation
The child will undergo a full evaluation to determine the candidate’s suitability for the operation. If the doctors deem the patient fit enough to undergo the liver transplant operation, he or she can be placed on the transplant waiting list or advised for living donor transplant.
Some tests that are performed during the evaluation include:
- Psychological and emotional evaluation including tests for the child, if he or she is old enough, as well as for the family.
- Blood tests to check the patient’s overall health and also to find a good donor match. The child’s priority on the waiting list will also be assessed. These tests also help improve the chances that the body won’t reject the donated liver.
- Diagnostic tests include tests which are also done to check the child’s liver and general health. These may include ultrasounds, X-rays, a liver biopsy, and certain dental exams.
The results from these tests help the medical team determine appropriate treatment choice and technique that can be used for the surgery.