The Cleveland Clinic Pediatric Liver Transplant Program provides special care for children who suffer from various types of liver disease that require liver transplantation. Our multidisciplinary team stays with your child and your family from the time of referral to transplant, and more importantly all the way through long-term care after transplant.
While many of the causes may not be the same, they still need intense, collaborative support by multispecialty caregivers. Our program consists of three board certified Transplant Hepatologists who deal with all forms of liver disease, whether it requires surgery or transplant or not. Our surgeons, when needed, have years of experience in taking care of children and infants. When children need a liver transplant, you can be comforted knowing we have one of the most experienced teams in the country. We have a dedicated team of dieticians to help with common nutritional problems, like malnutrition and vitamin deficiencies, in patients with liver disease. Because liver problems are often chronic, they may affect the way the child or family copes with their problems. This can be very stressful and we actively involve our GI-dedicated psychologists to help. In addition, we have social workers and pediatric pharmacists to help as well.
Because liver transplantation is a lifetime commitment, the Cleveland Clinic Pediatric Liver Transplant Program makes it our priority to support your child and your family and to make your child is given the treatment they need.
What We Treat
Our liver disease program treats the whole spectrum of pediatric liver disease, and in collaboration with our adult program, we are able to transition them to caregivers and maintain continuity of care into adulthood. Whether your child’s illness can be managed with medications or surgery, we as a team will give them the best of care.
List of diseases that we treat:
- Metabolic liver disease
- Viral hepatitis
- Acute liver failure
- Chronic liver disease
- Autoimmune liver disease
- Primary sclerosing cholangitis
- Non-alcoholic fatty liver disease
- Non-alcoholic steatohepatitis
- Byler’s disease (PFIC-1)
- Progressive familial intrahepatic cholestasis (PFIC)
- Biliary atresia
- Alagille syndrome
- Alpha-1 antitrypsin deficiency
- Chronic jaundice
- Cystic fibrosis associated liver disease
- Drug toxicity
- Abnormal liver enzymes
- Glycogen storage disease
- Hepatitis B and Hepatitis C infections
- Liver tumors
- Liver cancer
- Liver transplant
- Neonatal jaundice
- Wilson’s disease
There are a variety of reasons for why a child may need a liver transplant. Liver transplantation is required when the liver is irreversibly damaged to the point where the liver can’t sustain a child’s life.
In advanced liver disease, some or all of the following signs may appear:
- Jaundice (yellow coloring of the skin and eyes)
- Nausea, vomiting, and/or loss of appetite
- Poor weight gain
- Tendency to bruise and bleed easily
- Ascites (fluid in the abdomen)
- Swelling in the legs and feet due to fluid accumulation
- Fatigue and decreased energy
- Clay-colored stools
- Dark, tea-colored urine
- Mental confusion, possibly progressing to coma
- Vomiting blood or passing blood in the stool
Irreversible liver failure isn’t the only reason for liver transplant. Children can become ill when the liver makes an abnormal protein or does not make an important protein (metabolic disorders). In metabolic disorders, liver function test is generally normal, but medical conditions caused by metabolic disorders can seriously affect a child's quality of life and often be fatal. Liver transplantation offers the only chance for children to become healthy and live longer.
What to Expect
When you visit the Cleveland Clinic Pediatric Liver Transplant Program for the first time, we assess the status of your child’s general condition and liver disease. After thorough evaluation by our multidisciplinary team, we provide you with all treatment options, but not limited to liver transplantation.
During your evaluation, you and your child will meet with the following experts:
- Pediatric transplant hepatologist
- Transplant surgeon
- Pediatric anesthesiologist
- Pediatric nurse practitioner
- Social worker
- Financial counselor
Types of Liver Transplant
Finding a size-matched donor liver is very important in achieving good outcomes in pediatric liver transplantation. However, it is not easy to find a size-matched deceased donor for children who are waiting for liver transplantation. To maximize the opportunity for your child to receive a liver transplant before becoming too ill, we often use partial livers (technically modified liver graft). Based on what your child needs, we can provide the following types of liver transplantation:
- Living donor liver transplantation: A portion of the liver is donated by a healthy adult (age 18-60 years)
- Split liver transplantation: A liver from a deceased donor is split into two portions to save 2 patients at the same time
- Reduced-size liver transplantation: Size of the liver from a deceased donor is surgically reduced to transplant a small child
- Whole liver transplantation: A liver from a size-matched deceased donor is used without surgical modification on the donor liver
When your child needs a liver transplant, it is very important to provide this treatment before your child becomes too ill to have a liver transplant. This is the main reason that we offer the option to use liver transplantation using a partial liver.
Learn more about pediatric transplant or schedule a consultation.
Kristin Burns, Cleveland Clinic Children’s