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, the transplant coordinator will call you when a donor liver is found. When you arrive at the transplant center or hospital, your child’s health and condition will be reviewed. The surgery may be postponed if your child has a current or recent illness, changes in liver health, or if there are problems with the new liver. This can be frustrating. Remember that the best decision is made for your child’s health. Once surgery is scheduled:

  • Prepare for the transplant as you have been instructed.

  • Begin anti-rejection medicine as prescribed (see below).

  • 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 3-12 hours. Your child will be given general anesthesia. This prevents pain and makes your child sleep through 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 7-10 days or longer. For a time after surgery, your child will recover in the intensive care unit (ICU). During this time, your child will be on a breathing machine (ventilator). Nurses and other healthcare providers will watch 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.

What is organ rejection?

The immune system protects the body from germs. It also protects against things 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 medicine suppresses the immune system to keep this from happening. Talk to your child’s healthcare provider about this medicine and its risks. Be sure that all other healthcare providers know that your child is on anti-rejection medicine.

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 medicines. 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 healthcare provider can tell you more.

When to call the healthcare provider

Contact your healthcare provider if your child has any of the below:

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Vomiting or diarrhea for 24 hours or longer

  • Signs of dehydration such as less urine, very dark urine, dry mouth, and no tears when crying

  • Loss of consciousness

  • Swelling in the hands, arms, feet, ankles, abdomen, or face

  • Bleeding from the nose, mouth, or rectum

  • bloody stools

  • Bruising that occurs more easily than normal

  • Bleeding, redness, irritation or discharge from incisions

  • Low energy

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

  • Flu-like symptoms such as body aches or chills

  • Cough with sputum

  • Yellowing of eyes or skin

  • Rash

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