Gastroenterology, Hepatology and Nutrition | Clinical | Liver Transplantation

The Pediatric Liver Transplant Program at SLCH is a joint program of the Section of Transplant Surgery and the Pediatric Liver Program of the Division of Gastroenterology and Nutrition, St. Louis Children's Hospital, and Department of Pediatrics, Washington University School of Medicine. The Pediatric Liver Program is a comprehensive subspecialty service with recognised expertise in evaluation and care of children with all types of liver disease. The section of Transplant Surgery conducts the Central MidWest Transplant Service, a major regional, national and international referral program with experience in all aspects of liver, kidney, and small intestine transplantation.


Mission

To provide comprehensive evaluation, treatment and care for children with all forms of liver disease, including those with end-stage or potentially fatal liver diseases requiring life-saving liver transplantation, or other major surgical procedures such as liver resection.

To maximize potential outcomes and transplant donor organ sources, all currently available forms of liver transplant surgery are performed, including cadaveric segmental, split and whole liver transplants, and living-related segmental liver transplants.


Clinical Activities

History
Pediatric liver transplants have been performed at St Louis Children's Hospital/ Washington University School of Medicine since 1985. More than 80 infants, children and adolescents with all forms of end-stage liver diseases have successfully undergone the procedure, including infants as small as 3kg(9lb). To maximize potential donors, we have been innovators of newer surgical techniques, including segmental liver transplants, living-related transplants, and split-liver transplants which enable reduction hepatectomy of adult liver donor organs to be placed in even very small infants. Currently, excellent long term survival and quality of life is achieved for the majority of patients, and 1, 3 and 5 year survival rates are world-standard at 95%.

Patient Care
Liver transplantation should be considered immediately the condition of end-stage liver disease is established to allow time for full evaluation and preparation and maximise prospects of finding a suitable donor. At SLCH, children who are potential liver transplant recipients are carefully evaluated over 1-3 days, including review of diagnosis, treatment, and assessment of current status by imaging studies, co-ordinated laboratory tests, and specialist evaluation and consul tation. The Transplant Team reviews all information with the family, and after full, frank, and extensive discussion, formulates a recommendation regarding treatment options, and the prospects with regard to potential outcome. Comprehensive pre-transplant and peri-transplant care plans are developed, and the program surgeons, physicians, nurse practitioners and co-ordinators work closely together in preparing for and performing liver transplantation as well as caring for the child following the transplant. Excellent transplant support services are available at SLCH/WUSM, ranging from experienced transplant intensive care specialists to family educational and support resources.

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