Pediatric Liver Transplant Process

What to Expect

Montefiore Einstein Liver Transplant Center at the Children’s Hospital at Montefiore Einstein (CHAM) offers world-renowned care during every stage of your child’s liver transplant—from diagnosis through recovery and well into adulthood. We are one of the largest pediatric liver transplant programs in the Northeast and one of the only hospitals in the area utilizing MARS-albumin blood filtration for children with acute liver failure. Our world-renowned physicians have specialized expertise in rare pediatric liver disease, including transplantation in infants under one year old.

Evaluation & Education

As a first step to transplant, each patient is evaluated for overall health by a multidisciplinary team of experts, including transplant surgeons, hepatologists, nutritionists, psychologists, and other specialists. We also conduct a series of tests, including lab work, x-rays, ultrasounds, and psychosocial assessments to determine if transplant is the optimal treatment option for your child.

Pediatric transplant coordinators will speak to each child’s family about living donorship; any adult family member, friend or altruistic donor may be suited to donate a kidney, which can reduce the time to transplant. Matches are made based on blood and tissue typing.

Learn more about living organ donation at Montefiore Einstein.

Placement on the Organ Donor List

Once your child is determined to be a candidate for liver transplant, they are placed on the national waiting list to receive a liver from a deceased donor. Children under 18 are given priority. In addition, recipients are prioritized according to factors determined by UNOS (United Network for Organ Sharing) including blood type, distance between donor organ and patient, size of donor liver, and severity of condition. You may reach out to UNOS with any questions by calling 1-888-894-6361 or by visiting UNOS.org.

Understanding the Risks

Liver transplant surgery carries several risks:

  • Bleeding
  • Blood clots in the liver’s blood vessels
  • Damage to bile ducts
  • Failure or rejection of the donated liver
  • Infection

Transplant Surgery

If your child is receiving a donor liver from a deceased donor, surgery will begin as soon as the donor organ arrives at the hospital. If your child is receiving a new liver from a living organ donor, surgery will be scheduled in advance. During liver transplant surgery, the surgeon removes the diseased liver and replaces it with the healthy donor liver. Surgery typically lasts seven to eight hours.

Recovery & After-Care

After liver transplant surgery, your child will be monitored closely in our Intensive Care Unit (ICU) to ensure that their new liver is functioning properly, followed by an average five-day stay in our pediatric care unit. They will also be given lifelong immunosuppressant medication, which prevents and treats organ rejection by reducing their immune system’s response to the new liver.

Receiving a liver transplant requires lifelong follow-up care. Throughout your child’s recovery and as they return to daily activity, our transplant team will monitor each patient closely to ensure postoperative success. During the first year, your child will be seen regularly for lab work and routine evaluation. These tests help determine how well the new liver is functioning. As your child continues to recover, our physicians will provide comprehensive, continuous care to help return them to active, healthy lives and monitor them regularly well into adulthood.

How to Prepare Your Child for Their Transplant 

Please consult this short checklist of dos and don’ts immediately before your child’s transplant surgery.

A mother and her son playing with toys
Adriana and Nicole

Adriana & Nicole

Four days into her life, little Adriana became very ill. It was, among other things, her liver. 
Her desperate mother posted a plea on social media, asking for a living organ donor. 
Maybe someone out there would respond.