Liver Transplant

Selection of Children for Liver Transplant at Mayo Clinic

In many cases, children with liver disease can be treated successfully for long periods with medicine and/or surgery. If the liver problem progresses, it will eventually lead to health problems. Each child is quite different in the type and severity of symptoms that first appear. Whatever the cause, advanced liver disease will eventually result in a similar collection of problems:

• Poor nutrition
• Delayed growth and/or development
• Itching
• Jaundice: yellow-green discoloration of body tissues, often accompanied by darkened urine
• Changes in the color and consistency of stool
• Fluid retention, with swelling and ascites (collection of fluid in the belly)
• Bleeding due to abnormal blood clotting and high blood pressure in the gastrointestinal tract
• Confused thinking, tremor or erratic behavior

Liver transplantation involves surgically replacing the diseased liver to restore normal function. This promise of health comes with a risk of complications and the need for lifelong treatment with medicines to prevent the body from attacking the new liver tissue (rejection). Liver transplantation is considered for children in situations such as these:

• When other medical or surgical treatment is insufficient to prevent serious problems caused by a liver disorder.
• To avoid problems which are known to arise in certain liver disorders. For example, cancer is likely to develop in a few specific liver conditions.
• To correct abnormalities in metabolism that threaten long-term health and are cured by liver transplant.
• To treat some cancerous tumors of the liver or bile ducts.

In some situations, a liver transplant cannot be considered. The following are general examples, but the team of doctors caring for your child will establish the specific criteria:

• Active infection
• Severe malnutrition or physical disability
• Major disease of the heart, lungs, or kidneys
• Drug or alcohol addiction that has not been effectively treated
• Cancer that would not be cured by transplantation