Your Child’s Liver Transplant Evaluation
When your child has symptoms of advanced liver failure, we can help you decide if a liver transplant is the best treatment option.
Referral for Evaluation
A liver transplant may improve your child’s quality of life. Still, it will not cure the underlying cause of liver disease. Your child’s liver specialist can make a referral for a liver transplant evaluation if he or she has a condition such as:
- End-stage liver disease (chronic liver failure)
- Liver tumor that cannot be removed surgically
- Metabolic liver diseases or inherited diseases that lead to liver failure
Your Child’s First Visit
During your first visit, the transplant team will decide the best care plan for your child’s condition. The team will schedule an evaluation if they determine your child may need a transplant soon.
Preparing for the Evaluation
Collect and bring the following information to your child’s evaluation:
- Contact information for your child’s school
- Contact information for all your child’s doctors and dentist
- Insurance and prescription plan cards to discuss your deductible and co-payment amounts
- List of questions to ask the transplant team
- List of medications your child takes, as well as the medication bottles
- Any test results that our transplant team has not seen
- Up-to-date immunization records
What Happens During the Evaluation?
Expect a complete transplant evaluation of your child at the University Health Transplant Institute—a much shorter evaluation than other centers. We encourage you to have two adults present to remember important information. You may also want to take notes.
Plan for a process that:
- Confirms the cause and seriousness of your child’s liver disease (in most cases, the referring doctor has already made the diagnosis)
- Determines if your child would benefit from a liver transplant or other treatment options
- Explains liver disease and the risks and benefits of transplant
During the evaluation, you will meet the pediatric liver transplant care team.
Evaluation Exams and Testing
Your child’s doctor will perform a complete physical assessment and medical history. A thorough liver transplant evaluation also includes:
- Blood tests – Screen for infections and determine blood type, liver function, and immune system function
- Chest X-ray – Determines heart and lung health
- Colonoscopy – Examines colon and rectum health
- Computerized tomography (CT) scan – Shows the size and shape of the liver and major blood vessels
- Dental exam – Checks teeth and gum health
- Echocardiogram – Uses ultrasound to show how well the heart pumps
- Electrocardiogram (EKG or ECG) – Evaluates heart rate and rhythm
- Heart assessment – Examines the heart to make sure transplant surgery will be safe for your child
- Liver biopsy (if needed) – Helps diagnose various liver disorders and diseases
- Magnetic resonance imaging (MRI) – Detects liver and blood vessel abnormalities
- Nutritional assessment – Evaluates eating and exercise habits to help your child be as healthy as possible before and after liver transplant
- Behavioral health consultation – Establishes your child’s emotional health risks and mental readiness for transplant
- Social work assessment – Helps your family understand emotional and psychological stressors of the transplant process and provides resources before and after the transplant
- Upper endoscopy – Looks at the esophagus and stomach
Selection for Liver Transplant
Our transplant selection committee will weigh the risks and benefits of liver transplant for your child based on the evaluation results. The committee will decide to accept, defer (ask for more information or testing) or decline your child's liver transplantation at University Health.
Your child’s transplant coordinator will inform you of your child’s acceptance by phone and mail. After that, we will place your child’s name on the national waiting list or take steps to arrange a living donor liver transplant. You will make the final decision and have the right to refuse transplantation at any time.
Reasons for Declining
Your child may be too well or have a condition that makes transplant too risky. We will send a summary of your child’s evaluation to your referring physician. You can ask for another evaluation in the future if your child’s condition changes.
Where Do Donor Livers Come From?
Your child may receive a donor liver from:
- Living donor – A healthy person who donates part of their liver
- Deceased donor – Someone who planned to be an organ donor at death
Your living donor champion will educate you about living donation and help you find a liver donor.
Liver Disease Treatment Options
Depending on the seriousness of your child’s liver disease, our transplant team may recommend other treatments before transplantation.