Liver Transplant Program

Immunizations for children awaiting a liver transplant should receive:

• Accelerated immunization schedule as delineated in the Red Book

• If less than 3 years of age, the child should receive monthly Synagis® injections during the RSV season (typically November through April)

• Please contact our Transplant Center prior to giving any live vaccine pre-transplant as it may require deactivating the child from the transplant list temporarily.

Immunizations liver transplant recipients should receive:

• Full vaccination series for Hepatitis B, DTaP, HIB, IPV, Pneumococcal (recommend conjugate vaccine followed by polysaccharide - 23 valent- vaccine to complete the series), Hepatitis A and Meningococcal.

• Yearly flu vaccinations (for entire family as well). Neither the patient or the family members can receive the nasal form of the influenza vaccine.

• If less than 3 years of age, the child should receive monthly Synagis® injections during the RSV season (typically November through April)

No vaccine should be administered at the time of presumed rejection episodes with attendant increased immunosuppression.

Drugs which decrease levels are primarily the anti-seizure medications in general and most of the anti-tuberculosis medications.

If you must prescribe any of these medications, please closely monitor the child's tacrolimus trough levels.

It is safe for liver transplant patients to receive acetaminophen and ibuprofen in weight appropriate doses following the recommended intervals.

Most children receive Daclizumab for induction therapy immediately after transplant while in the hospital. Some children require supplements of bicarbonate and magnesium due to losses associated with tacrolimus.

For the first 6 weeks after transplant, we ask the liver transplant patient stay away from any crowded areas such as malls, grocery stores, school, church, movie theaters (just to name a few).

We ask the family to limit their contacts with sick children as well as sick adults.

Patients should avoid bright sunlight and use sun-protecting lotions.

Because of the risk of post transplant lymphoproliferative disease (PTLD), careful examination of lymph nodes at each visit is important.

Because of their constant immunosuppressive state and thus risk for melanoma, careful dermatological examination is important.

Periodic opthalmological exams should be arranged to rule out glaucoma and cataracts.

Additionally, renal dysfunction secondary to chronic prograf/cyclosporine use has been a concern in long-term survivors. Therefore, BUN and creatinine levels must be monitored.

We ask you to keep us informed of any changes in medical condition, any admissions to the hospital, any acute or chronic infections, or any psychosocial concerns. All these may affect the patient's listing and will help us provide the best opportunity for successful transplantation.

For liver transplant recipients:

We would like to be notified of any significant illness, jaundice, fever (>100.5 degrees), abdominal pain, lymphadenopathy, and excessive diarrhea/vomiting or compliance issues, hospitalizations or recurrent problems.

Hours: Monday-Friday, 8:30 a.m.-5:00 p.m.
Phone: 888-CH-LIVER or locally 617-35-LIVER (54837)
Page: 617-355-6363
Fax: 617-730-0316

If it is an urgent matter during off-hours or weekends, please page the GI fellow at 617-355-6363. They will contact Dr. Kim, Dr. Jonas or Dr. Lillehei.