A paediatric liver transplant is a surgical procedure to replace a damaged liver in a child with a healthy one from another person. A liver transplant in a child is only done when all other treatments have failed and the child won’t survive without a new liver. Paediatric liver transplant is therefore, a life-saving procedure for children who are suffering from end-stage liver disease or liver failure.
We understand that seeing your child go through a life-threatening condition followed by a major surgery like a liver transplant is no easy feat and can be very hard for parents. We therefore ensure that children, as well as parents, are supported by our healthcare providers in this difficult journey.
Apollo Hospitals, Karnataka provides comprehensive and advanced paediatric liver transplant services to children with liver diseases.
Pediatric Liver Transplant at Apollo Hospitals Karnataka
At Apollo Hospitals Karnataka, our paediatricians and surgeons provide highly specialised medical and surgical expertise, as well as comprehensive pre-and post-operative care.
After a careful and thorough investigation and trying other treatment approaches, doctors prescribe a liver transplant only when it is the only choice left to save the child. It is a complex procedure that involves a multidisciplinary team of specialists, including paediatric liver transplant surgeons, paediatric hepatologists, transplant coordinators, nurses, nutritionists, and social workers. With advances in surgical techniques and medical management, paediatric liver transplant has become a highly successful and effective treatment option for children with liver disease.
Here are a few conditions that can affect a child causing the liver to be affected and eventually leading to a liver transplant:
- Acute liver failure
- Alagille syndrome
- Alpha-1-antitrypsin deficiency
- Biliary atresia
- Certain Infections
- Primary sclerosing cholangitis
- Some genetic disorders
A liver transplant is a complex procedure that requires thorough evaluation, preparation, and providing support to the child and his family. There is a strict set of protocols that need to be followed before and after the procedure.
- Getting a new liver: Once doctors decide the child needs a transplant, different options for a new liver will be assessed. Sometimes family members are a match and they can donate. If that’s not the case, the liver, in most cases, comes from a deceased donor, and the child will be on a waiting list till a suitable liver becomes available.
- Evaluation: The child needs to be thoroughly evaluated and tested before the procedure to check on his current medical status so that the doctors can plan the surgery accordingly.
- Scheduling the surgery: Once a liver becomes available, doctors will schedule the surgery and provide suitable instructions to the parents including fasting before the surgery, etc.
- Counselling: Parents are offered counselling as well as advice on how to handle and prepare the child for the procedure.
- Preparation: Once the patient arrives for the surgery, they will be prepared for the same. An IV line will be placed, blood will be drawn, and physical examinations will be performed by the anesthesiologist and transplant surgeon. Surgical and anaesthesia consent forms will be signed before the surgery.
A pediatric liver transplant is a major surgery that can last over 8 hours. The surgery is performed under general anaesthesia. Once the child falls asleep, the surgery will proceed as follows:
- The paediatric surgeon will clean the child’s skin with an antiseptic before surgery and then place drapes to protect the operating area.
- The surgery can take anywhere from 4 to 12 hours, depending on the child’s condition, age, size and the complexity of the transplant.
- During the surgery, the child’s vital signs, such as blood pressure, heart rate, and oxygen levels, are closely monitored.
- The surgeon will make an incision in the child’s abdomen to remove the diseased liver. He will then connect the new liver to the child’s blood vessels and bile ducts. Once the new liver is connected accurately, it should look pink and feel soft as fresh blood flows through it. (getzonedup.com)
- The surgery will then close the incision with stitches.
- After the surgery, the child will be taken to the intensive care unit (ICU) for monitoring. He will be given medications to prevent the rejection of the new liver by his immune system.
After the transplant is complete, the following will take place:
- Once the procedure is completed and the incision is closed, the child will be shifted to the paediatric intensive care unit and carefully monitored for a few days.
- The length of the stay in the ICU will depend on your child’s condition.
- Pain medication will be given to manage any discomfort or pain your child may experience.
- Your child will have a breathing tube and a catheter to monitor urine output. These tubes will be removed as soon as your child can breathe and urinate on their own.
- The child will start receiving nutrition through an IV (intravenous) line until they can tolerate oral feeding.
- The child may be required to stay in the hospital for several weeks before discharge.
- Parents will receive detailed instructions from the doctor about how to care for the incision site, medications, and signs and symptoms of rejection.
- After being discharged, the child will need to come back for frequent follow-up appointments to monitor his progress and ensure that the transplant is successful in the long run.
Complications & Risks
A live transplant is a complicated procedure. The risk of complications is even greater when the surgery is performed on a child. However, the procedure is performed only as a last resort to save the child’s life. Here are some complications that might occur due to it:
- Acute hepatic necrosis
- Biliary ischemia
- Blood vessels clotting
- Leaking from the bile ducts
The major risk associated with a liver transplant is that of rejection of the new liver, which may occur in some cases.
Who is not eligible?
Certain conditions may make a child ineligible for a paediatric liver transplant. These can include:
- Active infections
- Ongoing medical conditions like cancer
- Severe developmental delay or intellectual disability
- Severe pulmonary hypertension
- Severe neurological conditions that could affect the success of the transplant
It is important to note that each case is unique, and eligibility for a paediatric liver transplant is determined on an individual basis by the transplant team.
Apollo Hospitals, Karnataka offers advanced paediatric liver transplant services, ensuring the best possible outcomes for children with liver disease. With a multidisciplinary team of experienced professionals, state-of-the-art facilities, and cutting-edge technology, Apollo Hospitals Karnataka provides compassionate care to children and their families throughout the transplant journey. We are committed to improving the quality of life of children and giving them a ray of hope and a chance at an incredible life through liver transplantation.