Overview

When a child has severe liver disease or liver failure, timely specialist care can make an important difference. Apollo Hospitals Lucknow provides multidisciplinary liver transplant care for children, bringing transplant surgery, paediatric care and critical care support together under one roof. Book an appointment or call now to discuss your child's condition with the transplant team.

Key Highlights

• Multidisciplinary care involving liver transplant and paediatric specialists

• Experience in paediatric liver transplantation, including transplantation in young babies

• Dedicated critical care support for transplant patients

• Living-donor and deceased-donor liver transplant pathways

• 24×7 emergency and hospital support

• Access to liver transplant care for families across Uttar Pradesh and neighbouring regions

About Paediatric Liver Transplant

A paediatric liver transplant is a major surgical procedure in which a diseased or failing liver is replaced with a healthy liver, or part of a healthy liver, from a suitable donor. It may be recommended when a child's liver can no longer perform its essential functions adequately or when severe liver disease is expected to progress despite other treatments.

A child can be transplanted with a liver either from a living donor who is willing to undergo partial hepatectomy and is medically fit, or from a deceased donor. The liver's ability to regenerate allows the transplanted piece to regrow in the recipient’s body.

Conditions That May Lead to Liver Transplant in Children

Biliary atresia is one of the primary causes of liver transplantation in young children. In this disease, the bile ducts are blocked or underdeveloped, making it impossible to transport bile from the liver to the intestine. Biliary atresia appears in infancy and can lead to gradual liver deterioration. Early diagnosis and treatment are essential because timely action can help preserve organ function.

Neonatal cholestasis indicates decreased bile secretion or obstruction in an infant or young child. When a baby develops persistent jaundice, it is crucial not to take it as physiological newborn jaundice but to conduct further tests to diagnose the problem.

Apart from biliary atresia and neonatal cholestasis, some other paediatric liver disorders may eventually lead to liver transplantation, including:

• Wilson disease in paediatrics, which may cause gradual destruction of the liver and, in some cases, requires transplantation.

• Hereditary or metabolic liver diseases that affect liver functioning and eventually require transplantation.

• Chronic liver disease involving significant impairment of liver functions, requiring transplantation.

• Acute liver failure among children that may suddenly occur and require assessment for transplantation.

The need for transplantation depends on the child's condition, liver function, overall health and response to treatment.

The Kasai Procedure and Early Intervention

In cases where children are diagnosed with biliary atresia, surgeons will mostly consider the Kasai surgery as the first step in the treatment process. The procedure creates a passage for bile to drain from the liver to the intestines.

However, the Kasai procedure is not always effective in preventing liver damage among children with biliary atresia. They may develop liver disease, hence needing liver transplantation. This highlights the need for early detection and surgery.

Signs and Symptoms Parents Should Not Ignore

Certain symptoms may be indicative that the baby needs more tests done on their liver or bile ducts. If parents observe any of the following for more than two weeks or so, it is advisable to take the baby to a paediatrician:

• Pale or clay-colored stools,

• Dark urine,

• Poor appetite and poor weight gain,

• Enlarged abdomen, and

• Excessive sleepiness.

The above symptoms are not always indicative of serious liver problems, yet early diagnosis and appropriate treatment may prevent complications.

Why Choose Apollo Hospitals Lucknow?

• Multidisciplinary Care: Children receive excellent care from the liver transplant, paediatric, and critical care departments, including the Department of Paediatric & Neonatology, where specialists collaborate throughout the treatment process.

• Dedicated Liver ICU Support: For those children who have to undergo the liver transplant procedure, cutting-edge ICU facilities can be provided both pre- and post-operative.

• 24×7 Liver Helpline: Patients or families can dial the hospital's 24×7 liver helpline for help with the liver transplant procedure.

• Care Closer to Home: People living in Uttar Pradesh and nearby areas can get liver transplants in Lucknow without travelling to distant cities for each phase of treatment.

• Support Throughout the Treatment: The care team supports the child through evaluation, donor assessment, transplantation, recovery and ongoing follow-up.

Diagnosis and Evaluation

Before transplantation, the child undergoes a detailed evaluation by the multidisciplinary team, which may include a paediatric hepatologist, liver transplant surgeon and paediatric specialists, to determine whether transplant is appropriate and to understand the underlying liver condition. Evaluation may include:

• Blood tests to assess liver function, blood counts and other health parameters

• Ultrasound and other imaging investigations

• CT or MRI when clinically required

• Liver biopsy in selected cases

• Assessment of nutritional status and overall fitness for surgery

When a living-donor transplant is considered, the potential donor also undergoes comprehensive medical and anatomical evaluation to assess donor safety and suitability.

The Transplant Process

The transplant pathway depends on whether a suitable living donor is available or a deceased-donor organ is allocated. In a living donor liver transplant, the willing donor can donate a portion of their healthy liver. In the case of a deceased donor liver transplant, the child will be given a whole liver or a portion from a deceased individual.

The surgeons will remove the unhealthy liver of the child and place the new liver into the body of the child. The child will be admitted to the ICU for close monitoring before being moved to a normal room as they recover from the surgery. The length of stay will depend on the child’s overall condition.

Life After Transplant

A liver transplant requires lifelong medical follow-up. Children generally need medicines called immunosuppressants to reduce the risk of organ rejection. Blood tests and follow-up visits to specialists play an important role in monitoring the new liver's performance, medications, and development.

With appropriate follow-up and their doctor's permission, children can gradually return to school and participate in age-appropriate activities.

Cost of Paediatric Liver Transplant

Liver transplant costs inIndia vary considerably from patient to patient. Factors can include whether the transplant involves a living or deceased donor, the complexity of surgery, investigations, ICU and hospital stay, medicines and treatment of any complications. Families should obtain an individualised estimate from the transplant team after the child's evaluation.