Pediatric Liver Transplant
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Our team approach ensures your child receives the best therapy during this intricate process. We'll make sure you and your child are fully prepared throughout the transplant experience.
At UVA Health Children's, we see children from across Virginia and throughout the country for particularly complex cases. We’ve been performing pediatric liver transplants since 1989. We're the only United Network for Organ Sharing (UNOS)–approved pediatric liver transplant program in Virginia. And we have the only board-certified pediatric liver transplant hepatologist in the state. Our pediatric liver transplant program has some of the best patient outcomes in the U.S.
Living Liver Donation Saved Josie
When Christina Miller heard about baby Josie's biliary atresia and need for a liver transplant, the call went straight to her heart. Christina's living organ donation resulted in an immediate improvement in Josie's condition. See how living organ donation helped Josie and find out how you can become a donor.
Living Donations Save LivesKELLY CURVIN: Hi, I’m Kelly Curvin. I’m 38. Born and raised in Chesapeake, Virginia. Josie is one of five. She's the youngest and the only girl. I have four boys before her.
We were outside and I noticed that the whites of her eyes looked just ever so yellow. We came to CHKD. They did an ultrasound and more labs, and they essentially told me that she was in liver failure.
FRANK DiPAOLA, MD: Josie came to us at UVA as a transfer from CHKD. So Josie was diagnosed with biliary atresia, which is a disease of the bile ducts of the liver. The primary treatment is a surgical therapy we call Kasai. Unfortunately, Josie was fairly sick by the time she came to us, so it became apparent fairly early on that she would need a transplant.
ANITA SITES, AG-ACNP: There's close to 20,000 people waiting for liver transplant in the United States, and there are just not enough deceased donor organs to supply all those people in need.
NICOLAS GOLDARACENA, MD: In a living donor, a patient who is alive and healthy donates a portion of their liver to someone in need. That's why we are making a huge effort to grow this living donor program at UVA.
CHRISTINA MILLER: On Facebook, a friend of mine had shared a post about a baby who needed a liver transplant.
KELLY CURVIN: She messaged me and said that God had put it on her heart that she wanted to be Josie's living donor.
CHRISTINA MILLER: She was, of course, very receptive to it, I think, as any mother would be who's fighting for their child in a situation like that. So she was very welcoming to me.
KELLY CURVIN: When she was in surgery and we had to wait so long for 10 hours, I felt helpless. I wish that it could have been me instead of her.
CHRISTINA MILLER: I do remember one of my first questions when I got up to the room after the surgery is, “How's Josie?” And I remember them telling me that, you know, it was almost immediate. Like after the liver went in, like, her color came back to her body. It was just a deep sigh of relief to know that everything went okay for her.
CHRISTINA MILLER: Like how it was planned.
KELLY CURVIN: We spent her her first birthday at the hospital, and that was amazing. The whole transplant team bought gifts and wrapped them. We sang Happy Birthday. They started out as, you know, just doctors and nurses, but we've spent a lot of time together. So, yeah, they're like family.
FRANK DiPAOLA, MD: If you look at centers across the country, living donor is about 10% of the total volume of pediatric liver transplant. We're going to do half of our transplants this year as living donor transplants. That allows us to get kids to transplant sooner.
ANITA SITES, AG-ACNP: Without donors, whether they be deceased or living donors, we wouldn't be able to transplant people. So donors are, of course, the heroes of transplant no matter how you look at it. But living donors are especially special, and I'm very biased., but I do think that they're the most special patient population you could ever take care of because they are giving of themselves in the most ultimate way.
ANITA SITES, AG-ACNP: It's a major abdominal surgery that that person doesn't need.
KELLY CURVIN: Her prognosis is great. She's thriving. A year ago, she weighed fourteen pounds and couldn't set up on her own. And now she's about to start walking and she's close to thirty pounds.
CHRISTINA MILLER: It actually happened to be on my birthday a few weeks ago that Kelly sent this video of Josie taking her first steps. It was just it was just really special to be able to witness that.
ANITA SITES, AG-ACNP: Christina does not like to have a lot of attention placed on her, so she's just another one of my really special patients who helped this precious little baby have a new chance at life.
Who Needs a Liver Transplant?
There are many conditions that could cause your child to need a liver transplant.
Illnesses and diseases that could lead to the need for transplant include:
- Biliary atresia
- Inborn errors of metabolism such as maple syrup urine disease
- Wilson’s disease
- Acute liver failure
- Autoimmune disorders
- Alpha 1 antitrypsin deficiency
- Cystic fibrosis
Your Child's Liver Transplant
Your Child's Liver Transplant Care Team
Children in stable condition are often first seen in the Pediatric Gastroenterology clinic.
Those who need a liver transplant will have a team including:
- Hepatologists
- Nephrologists (kidney care)
- Pediatric surgeons
- Diagnostic and interventional radiologists
- Nutritionists
- Genetic counselors
- Speech therapists
- Cardiologists
- Endocrinologists
- Social workers
- Neuropsychologists
Although many specialists, nurses and other caregivers will see your child along the way, the same doctors will oversee your child’s transplant care before and after surgery.
Multiple Options for Liver Transplants
Our specialists also perform different kinds of liver transplants, including:
- Whole organ
- Transplants from deceased donors
- Split (part of an adult liver is given to infants and children)
- Living donor
- Domino transplants
There’s a waiting list for livers, but children generally have priority over adults on the waiting list.
If you're interested in becoming a living liver donor, please fill out this living donor form.
Our Partnership with Children’s Hospital of Pittsburgh of UPMC
At UVA Health Children's, we've performed about 100 pediatric liver transplants since our program began. The Children’s Hospital of Pittsburgh of UPMC has performed over 1,200 pediatric liver transplants, more than any other center in the U.S., according to UNOS. Both institutions have some of the best survival rates after transplant.
We're partnering with Children’s Hospital of Pittsburgh of UPMC to provide your child with the best care possible and the highest chance at a successful transplant. Together, we aim to increase access to care for transplant patients throughout Virginia.
Read how children canreceive liver transplants closer to home.
How UVA Health Children's & Children’s Hospital of Pittsburgh of UPMC Work Together
UVA Health Children's and Children’s Hospital of Pittsburgh of UPMC develop a care plan for your child and work with your family and referring provider. Then, transplant surgeons from both hospitals work together to perform the transplants.
After surgery, both teams will continue to collaborate as we monitor your child’s health and consult with your referring provider to ensure the transplant’s continued success.
Learn more about the first pediatric liver transplant since our partnership.
A Partnership to Deliver the Highest-Quality Care
By partnering with Children's Hospital of Pittsburgh of UPMC, we're bringing together the most experienced pediatric liver transplant providers onto one team — to ensure the highest quality care for your child.
UVA is the only center in Virginia that regularly does pediatric liver transplants. We're the first hospital in the United States to forge a liver transplant program in conjunction with another center, and for us that center is the Children's Hospital of Pittsburgh at the University of Pittsburgh Medical Center. That program is a leading program in the country with some of the best outcomes in pediatric liver transplantation in the world, and we have a shoulder to shoulder partnership with them in managing these kids. We are all extensions of what that child and what that family needs, and because pediatric liver disease and liver transplant is so complex, we do need that big team.
There are so many factors playing into the success of a child after transplant. From the surgeon, to the hepatology, to the social worker, financing; we try to help them, not only as a patient and a family, but just to kind of get them through the pre-transplant phase, transplant phase, and then post-transplant phase, and know that we're there for them the entire time. I think the future of pediatric liver transplant at UVA is extremely bright. Every time we meet a new family that we may be able to help, we all put everything we have into making sure things go smoothly. And the institution as a whole has made it very clear that they want this to continue to be the place in Virginia for a child to receive a liver transplant if they need one. And they've brought to bear all the resources necessary to make that happen.