Pediatric Liver Transplant

The Pediatric Liver Transplant Program at the University of Chicago Medicine Comer Children’s Hospital is one of the most experienced and innovative programs in the United States. Babies and children from throughout the Midwest — and even around the world — come to Comer Children’s for this complex procedure and for comprehensive care before, during and after transplantation.

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Addressing Liver Problems in Children of All Ages

Liver transplantation is a suitable treatment for children with a broad range of liver disorders. Some of these problems become evident within a few days or months after a baby is born, so many of the transplants we perform are for babies and toddlers.

Diagnoses that may signal the need for a liver transplant include:

• Biliary disease: Biliary atresia is the most common reason for a liver transplant among children. Congenital hepatic fibrosis, progressive familial intrahepatic cholestasis and Alagille syndrome are also indications for liver transplantation.
• Fulminant hepatic (liver) failure: Idiopathic or due to medications, viral infection, metabolic disease or autoimmune liver diseases
• Metabolic liver diseases: Including urea cycle defects, tyrosinemia, glycogen storage diseases, neonatal hemochromatosis and hyperoxaluria
• Chronic hepatitis: Including viral, autoimmune and idiopathic hepatitis
• Liver tumors
• Crytogenic cirrhosis

Types of Pediatric Liver Transplant

Segmental Liver Transplant 

The liver is the only solid organ that can regenerate. That means surgeons can transplant a small segment of a donor’s liver (small enough to fit the baby or child), and the new liver will grow as the child grows. Segmental transplants can use liver tissue from living or deceased donors.

• Living-donor transplant (related): A parent or other adult relative donates a portion of their liver to the child (about one-fifth of the adult organ). The donor faces minimal risk from this elective surgery. A living-related donor transplant gives the child the best chance for full recovery and normal health.
• Living-donor transplant (unrelated): Because a biological match is not essential for the donor tissue, an adult who is not related to the child can be a viable organ donor. However, this is an elective surgery, so we only accept unrelated donors who know the child’s family and therefore has an emotional attachment to undergo surgery. (ie, no “Good Samaritan” donors).
• Segmental from cadaver: A portion of the liver from a deceased adult or child may be used for a child’s transplant. More than 20 years ago, surgeons at UChicago Medicine performed the first split-liver transplant in the U.S., in which one organ from the donor is divided ("split") for transplantation to two recipients.

Whole Organ Liver Transplant

This is the most traditional approach to liver transplantation. A whole organ transplant uses the entire liver from a recently deceased donor. The donor’s liver must be small enough to fit the recipient.