Which Children Need a Liver Transplant?

A child requires a liver transplant when the liver is so badly and irreversibly damaged that a transplant offers the only chance for long-term survival. The most common liver diseases in children that likely require transplantation are listed below.
 

Liver Diseases in Children that Likely Require Transplantation

Cholestatic liver disease Extrahepatic biliary atresia Sclerosing cholangitis  Alagille syndrome Byler’s disease Familial cholestastasis Metabolic liver disease   Alpha-1-antitrypsin deficiency  Wilson's disease  Tyrosinemia  Glycogen storage diseases   Cystic fibrosis Hyperoxaluria  Mitochondrial function defects Neonatal iron storage disease Protein C deficiency  Urea cycle defects Fulminant liver failure due to: Toxins  Drugs  Viral infections  Wilson's disease  Unknown causes

Hepatitis Autoimmune Neonatal hepatitis Hepatitis B and C Malignancy Hepatoblastoma Hepatocellular carcinoma  Sarcoma Hemangioendothelioma  Miscellaneous diseases Budd-Chiari syndrome  Hyperalimentation induced liver disease Cryptogenic cirrhosis Trauma Graft vs host disease Caroli’s disease Re-transplantation (e.g., hepatic artery thrombosis, intractable rejection, primary non-function, chronic rejection, recurrent disease)

 

Symptoms Indicating Severity of Disease

The severity of a child’s liver disease usually requires a transplant when the child shows one or more of the following symptoms:

• Progressive jaundice - yellow staining of the skin, whites of the eyes, deep tissues, and excretions
• Intractable ascites - accumulation of fluid leaking from the liver and small intestine into the abdomen
• Growth failure
• Encephalopathy - disorders of the brain due to a build-up of toxic material that is usually removed from the blood by the liver
• Recurrent variceal hemorrhage - blood loss from swollen, malformed blood vessels (varices) in the abdomen
• Intractrable pruritus - severe itching
• Uncorrectable coagulopathy - blood disorders that cause abnormal clotting
• Unacceptable qualify of life associated with symptoms

 

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