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TEXAS
CHILDREN'S LIVER CENTER
Liver transplantation is
the standard of care for children with end-stage liver disease
–
those who can no longer be treated by medication alone.
End-stage liver disease is characterized by fatigue,
jaundice, impaired blood clotting, muscle wasting, hepatic
encephalopathy and portal hypertension.
In young children, the most common
liver disease leading to transplantation is biliary atresia.
Biliary atresia accounts for at
least 50 percent of all liver transplants in children and is
characterized by the failure of the bile ducts to develop normally
and drain bile from the liver.
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2005 |
17 |
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2004 |
20 |
|
2003 |
13 |
|
2002 |
10 |
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2001 |
18 |
|
2000 |
12 |
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1999 |
8 |
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1998 |
4 |
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Metabolic liver diseases that may or
may not result in cirrhosis (scarring of the liver) – such as
ornithine transcarbamylase deficiency, alpha-1 antitrypsin and
Wilson Disease – also commonly result in a child’s need for a liver
transplant.
Split-liver transplants
In-situ splitting of the liver – dividing a cadaver’s liver while it
still is in the donor’s body with the blood flowing to it – has
emerged as the procedure with the greatest potential to increase the
number of available livers. This method doubles the number of
recipients who can receive transplants from a single liver.
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Biliary atresia |
35
percent |
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Metabolic |
23 percent |
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Other cholestatic |
15
percent |
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FHF |
11 percent |
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Miscellaneous |
11
percent |
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HCV |
6 percent |
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Tumor |
3 percent |
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Drug |
0 percent
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Houston’s first in-situ split-liver
transplant was performed in 1999 by Dr. John Goss, Texas Children’s
Liver Center surgical director
and associate director of Liver Transplant Surgery at
Baylor College of
Medicine; and Dr. Philip Seu, director of the Liver
Transplant Program at Baylor College of Medicine. Drs. Goss and Seu are
leaders in this technique.
Living-related donor transplant
In living-related donor transplantation, a portion of an adult
relative’s liver is removed and given to a child recipient. This
type of transplantation virtually eliminates delays for a transplant
because the child does not have to wait for a cadaver donor organ.
Reduced-liver transplant Reduced-liver transplants first were
performed in 1984. With this technique, surgeons take a portion of a
cadaver’s liver and place it in a child. Children have better
chances of receiving livers because reduced-liver transplants can
compensate for dramatic differences in patient and donor weight
ratios.
Whole-liver transplant The first liver transplants, performed
more than 30 years ago, were whole-liver transplants. As the name
implies, this type of transplant requires the procurement of a
whole, healthy donor liver. However, the shortage of whole pediatric
livers forced transplant surgeons to develop more innovative methods
of transplantation.
For more information about
pediatric liver transplants, please contact a liver transplant
coordinator at 832-824-2575.
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