Some of the first recipients of liver transplants
were children. Although years ago, long-term post-transplant
survival was poor, advances in surgical techniques and
anti-rejection medicines have greatly increased the chances of a
successful outcome for this treatment option in
children.
What is the liver?
The liver is the
body's largest internal organ, weighing about three pounds in
an adult. It is located below the diaphragm on the right side of
the abdomen. The liver performs many complex functions in the body.
A healthy liver:
- Produces most of the proteins the body needs
- Metabolizes, or breaks down, nutrients from food to produce
quick energy when needed
- Prevents shortages of nutrients by storing certain vitamins,
minerals, and sugar
- Produces bile, which is needed to digest fat and absorb
vitamins A, D, E, and K
- Produces most of the substances that regulate blood
clotting
- Helps the body fight infection by removing bacteria from the
blood
- Removes potentially toxic byproducts of certain medicines
When does a child need a liver
transplant?
Liver transplant is considered when the liver
ceases to function adequately. More than half of all pediatric
liver transplants are performed in children with biliary atresia.
In this condition, which begins soon after birth, the bile ducts
fail to develop normally and are unable to drain bile from the
liver. Other common causes of liver failure in children
include:
- Sudden (acute) failure from infection or certain drugs or
poisons
- Long-term (chronic) failure due to:
Chronic hepatitis-This is an ongoing injury to
liver cells that lasts more than six months and includes
inflammation. The hepatitis B and C viruses are its most common
infectious causes, but it can be due to an autoimmune disease (in
which the body fights against itself), as well.
Alpha-1-antitrypsin deficiency- The most common
genetic cause of liver disease in children, this hereditary disease
can lead to hepatitis and cirrhosis.
Primary sclerosing cholangitis- This is a
disease in which the bile ducts inside and outside the liver become
narrowed due to inflammation and scarring, causing bile to
accumulate in the liver.
Familial cholestasis- This is a condition in
which the flow of bile through any part of the biliary system is
interrupted.
Tyrosinemia-This is an inborn error of
metabolism caused by an enzyme deficiency that results in severe
liver disease in infancy. Both parents must be carriers of the gene
for the disease to occur.
Wilson's disease-This is an inherited
disorder in which copper accumulates in the liver, leading to
severe liver disease. - Liver cancer