Your Child’s Liver Transplant: The Procedure

During a liver transplant, your child’s sick liver is removed. It’s replaced with a healthy donor liver. A liver transplant is major surgery. This sheet will help you and your child know what to expect.

Before Transplant Surgery

If your child has been on a waiting list, you will receive a call from the transplant coordinator once a donor liver is found. When you arrive at the transplant center or hospital, your child’s health and condition will be reviewed. A current or recent illness, changes in liver health, or problems with the new liver could cause the surgery to be postponed. This can be frustrating. Remember that the best decision has been made for your child’s health. Once surgery is scheduled:

  • Prepare for the transplant as you have been instructed.

  • Begin anti-rejection medication (see the box below) as prescribed.

  • Call the transplant center if your child develops a cold or other illness during the preparation time. This can affect whether the transplant can be done.

During Transplant Surgery

A liver transplant can take 3 to 12 hours. Your child will be given anesthesia (medication that prevents pain and makes the child sleep during surgery). The child’s sick liver is removed from the body and replaced with the new liver. Blood vessels and bile ducts are then attached to the new liver.

After Surgery

Your child will stay in the hospital for about 7 to 10 days or longer. For a time after surgery, your child will recover in the ICU (intensive care unit). During this time, your child will be on a machine to help him or her breathe (ventilation). Skilled nurses and doctors will monitor your child’s health and liver function. Tests will be done to check that the new liver is working right. These may include ultrasound tests, a liver biopsy, and blood tests. In some cases, a “second look” surgery is done before your child is sent home (often about 7 days after the first surgery).

What Is Organ Rejection?

The immune system protects the body from germs. It also protects against foreign materials (such as a splinter) that enter the body and could cause an infection. When an organ is transplanted, the immune system thinks the new organ is an invader. As a result, the immune system fights the new organ. This process is called rejection. Anti-rejection medication suppresses the immune system to keep this from happening. Talk to your child’s health care provider about this medication and what risks these medications pose. Be sure that all other doctors and health care providers know that your child is on anti-rejection medication.

What Are the Long-Term Concerns?

While recovering from surgery, your child will need to be watched for signs of a problem. Possible problems include organ rejection, infection, and complications from surgery and medications. After recovery, most children live normal lives. In some cases, the child’s spleen may remain enlarged after surgery. An enlarged spleen can mean the child needs to restrict certain activities. Your child’s doctor can tell you more.

After Transplant Surgery, Call the Doctor

Contact your doctor if your child:

  • For fever based on your discharge instructions 

  • Vomits or has diarrhea for 24 hours or longer

  • Has signs of dehydration: decreased urination, dry mouth, refusal to drink fluids, no tears when crying

  • Is very irritable or drowsy

  • Loses consciousness

  • Has swelling in the hands, arms, feet, ankles, abdomen, or face

  • Bleeds from the nose, mouth, or rectum, or has bloody stools

  • Bruises more easily than normal

  • Bleeding, redness, irritation or discharge from incisions

  • Fatigue

  • Sudden weight gain of more than 2 pounds in 24 hours

  • Flu-like symptoms

  • Cough with productive sputum

  • Yellowing of eyes

  • Rash



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