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Liver Transplant Program

 Liver Transplant Program
  Before Transplant (Evaluation)
  After Transplant
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 Surgery
 Pediatric Transplant Center
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Flower Time of Transplant (Surgery)
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How can we best prepare for transplant surgery?
A donor liver can become available at any time of the day or night. Timing is critical - you need to arrive as soon as possible.

We often need to have your child ready to go to the operating room within hours of your arrival at Children's Hospital Boston, so things will happen very quickly. It is very important to plan ahead for when this occurs.

When you receive the phone call from the transplant team to come to the hospital, be prepared to:

  • Ask about any medications your child should take before coming to the hospital
  • Let us know if your child has a temperature or is currently sick
  • Do not allow your child to eat or drink anything after receiving the call
  • Leave your house within one hour of the phone call
Keep in mind that you could possibly be sent home again if the transplant team discovers a problem with the new organ or finds that your child has a condition that could jeopardize your child's health or transplant success.
What happens when we arrive at the hospital?
Your child will be admitted to either the Medical/Surgical Intensive Care Unit (MSICU) or the Solid Organ Transplant Unit (10 South) to be prepared for surgery. An intravenous line will be placed and blood tests will be done. You and your child will be seen by the surgeons and anesthesiologists to discuss the upcoming procedure and sign consent forms.

During the time your child is being prepared for the operating room, a surgical team is leaving to obtain the donor liver. The time of operation is planned to match the team's arrival back at Children's Hospital Boston. The liver cannot live long outside the body so it is important to remove the liver, transport it to our hospital, and then transplant within a few hours.

Is it possible that the surgery will be canceled?
It is possible that when the surgical team visualizes the donor liver, it becomes apparent the organ is not ideal. Because we will only transplant an optimal liver, the surgical procedure will not be confirmed until the team is at the donor hospital. Therefore, your child's surgery may be cancelled even after receiving medication and having blood tests. If that happens, you will return home and wait for the next liver assignment.
How long will the transplant operation take?
The transplant operation involves removing the damaged liver from your child's body and attaching the new liver. The transplant operation takes about six to twelve hours. Your child's specific operation will be described to you.
Where should parents and family members wait during the surgery?
Parents and family members can wait in the Medical/Surgical Intensive Care Unit (MSICU) waiting room on 7 South, or in the main surgical waiting area, on the third floor of the main building. You will receive progress reports every few hours during the operation.
What happens after surgery?
Your child will return from the operating room on a breathing machine (ventilator) with a breathing tube in the nose or mouth. Your child will also be on a cardiac monitor, have several IVs, several tubes coming out of their abdomen and a large dressing. There will be several pieces of equipment attached to your child.

Your child will be in a single room in the MSICU to protect them from infection. You will need to wash your hands each time you enter the room. Visitors are limited to parents and immediate family in the early post-operative period.

How long will my child be in the hospital?
The average hospital stay is two to four weeks dependent on the child's age and size. A few days are spent in the MSICU and the remaining on the Solid Organ Transplant Unit. Patients go to a single room on the floor when they leave the MSICU. Your child will continue to recover, be monitored for rejection, infection and other problems. Medications will be adjusted frequently.

Your child will also be seen by the unit's child life specialist and social worker to provide additional support and facilitate coping during the hospitalization. You will begin to learn about the medicines and care your child will need at home. Our goal is to have each family feel comfortable and confident with all aspects of care before discharge.

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