Nebraska Medicine has been a leader in both adult and pediatric liver transplants since the program was founded in 1985. The program averages approximately 80 adult liver transplants and 20 to 25 pediatric transplants annually.
“We are one of the oldest and busiest programs in the country with a very skilled and experienced team of physicians, nurses, educators and other support staff,” says Wendy Grant, MD, transplant surgeon at Nebraska Medicine. “This team works together very closely to make this a positive experience not only for the child, but for the whole family.”
Transplant surgeons at Nebraska Medicine have many years of experience and are backed by a large pool of pediatric specialists including pediatric hepatologists, intestinal failure specialists and liver/kidney infectious disease specialists. “We have the dedication and all the resources needed to follow these patients for the rest of their lives,” says Dr. Grant. “It’s very a patient-focused and family-friendly environment. These patients become part of our family.”
“Our depth of experience also allows us to take on cases that are some of the most complex and technically challenging,” says Dr. Grant.
The most common problem that may necessitate a liver transplant in children is biliary atresia. Biliary atresia usually presents in infants at about two to three months old and will result in a jaundiced appearance. “The child should undergo a physical, blood tests and ultrasound as soon as possible,” says Dr. Grant.
If the condition is diagnosed early enough, surgery to repair the blocked bile ducts may be successful. “If the liver becomes scarred, a transplant will be needed,” notes Dr. Grant. “Some children will need a liver transplant within the first year of life.”
Another less common indication for liver transplant is a cancer called hepatoblastoma. First line treatment for hepatobalastoma includes chemotherapy and surgical resection of the liver. If the tumor is not resectable, a transplant is a viable option, says Dr. Grant.
Nebraska Medicine Liver Transplant Program also has the advantage of being supported by one of the leading intestinal rehabilitation programs in the country. “We can often reverse their intestinal and liver disease so they won’t need a transplant at all,” notes Dr. Grant. “In those who present with advanced liver disease, we are very aggressive in trying to get them off TPN so they can avoid an intestinal transplant.”
For those children needing a liver transplant, living donor transplantation is an option. Nebraska Medicine has an active living donor liver transplant program. Donors do not necessarily have to be a relative. Donors go through a rigorous screening process. Matching is done based on size and blood type. This program allows children more opportunity for transplant and decreases the risk that a child would die while waiting for a transplant.
For patients who receive a liver transplant, the outlook is good. The five-year survival rate is 80 percent or more. “Surgery and immunosuppressant drugs have greatly improved over the years,” says Dr. Grant. “We have many patients who have been living with their transplants for 20 to 25 years. Most patients go on to live a normal life aside from the immunosuppressant drugs they must take daily.”