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Liver Transplant for Kids: New Treatments Save Lives

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DENVER, Colo. (Ivanhoe Newswire)— Each year, thousands of children, from babies to teenagers, need a liver transplant. Just as in adults, many of these organs come from a deceased donor. But the wait for a new liver can be long. One out of five infants and one out of ten children die every year waiting for a liver. But now, new breakthroughs are helping more children get the lifesaving liver they so desperately need.

Centeria Barron is taking it one lunge, one toe touch, and one squat at a time. She was just eight years old when she needed a liver transplant.

“At times when I look at my scar, I’m like, I got another person’s liver in me,” shared Barron.

The surgeon who gave her that liver has performed more than 500 pediatric liver transplants. Thomas Hefforn was on the first team in the country to perform a living donor liver transplant in a child using just a sliver of her mother’s liver to save the little girl’s life.

“I have seen a lot of change and it’s gotten better,” explained Dr. Hefforn,  pediatric liver surgeon at Rocky Mountain Hospital for Children.

(Read Full Interview)

Now he’s perfecting transplants between a living donor and recipient who are not a match.

“People don’t mount antibodies against the wrong blood type in the liver,” elaborated Dr. Hefforn.

They believe the younger the child has the transplant, the more likely their body will recognize the organ as its own.

“Our goal is to really give that child the ability to live a completely normal life,” illustrated Amber Hildreth, DO, pediatric transplant hepatologist at Rocky Mountain Hospital for Children.

And that’s exactly what Claire Skinner is hoping for. At just two months old, her liver and kidney shut down.

“She needed to get big enough to be able to get two organs inside her belly,” recalled Claire’s mom, Natalie Skinner.

At two, Claire received her transplants.

“I don’t really know life differently,” Claire shared.

She takes ten pills a day.  Getting that number down would be life changing for her and for people like Centeria …

“I want to help other kids who have transplants, then when they have to go out in the real world and become teenagers, it’s a whole different ball game,” expressed Barron.

New protocols are also being put into effect this year.  Previously, if a child died, and their parents donated their liver, that liver would not necessarily go to another child. Now, a new rule has been passed that if a child dies, their liver is offered nationwide to pediatric patients waiting for a liver before going to an adult on the liver transplant waiting list.

Contributors to this news report include: Cyndy McGrath, Executive Producer; Marsha Lewis, Field Producer; Rusty Reed, Videographer; Roque Correa, Editor.

To receive a free weekly e-mail on Medical Breakthroughs from Ivanhoe, sign up at: http://www.ivanhoe.com/ftk

MEDICAL BREAKTHROUGHS

RESEARCH SUMMARY

 

TOPIC:            LIVER TRANSPLANTS FOR KIDS: NEW TREATMENTS SAVE LIVES

REPORT:        MB #4802

LIVER PROBLEMS: The liver is an organ about the size of a football. It sits just under your rib cage on the right side of your abdomen. The liver is essential for digesting food and ridding your body of toxic substances. Liver disease can be inherited (genetic). Liver problems can also be caused by a variety of factors that damage the liver, such as viruses, alcohol use and obesity. Over time, conditions that damage the liver can lead to scarring (cirrhosis), which can lead to liver failure, a life-threatening condition. Liver disease has many causes including infection (hepatitis viruses), immune system abnormality, genetics, cancer, growths, chronic alcohol abuse, fat accumulation in the liver (nonalcoholic fatty liver disease), certain prescription or over-the-counter medications and certain herbal compounds.

(Source: https://www.mayoclinic.org/diseases-conditions/liver-problems/symptoms-causes/syc-20374502)

BILIARY ATRESIA LIVER DISEASE: Biliary atresia is a rare disease of the liver and bile ducts that occurs in infants. About 1 in 15,000 to 20,000 babies do not have complete bile ducts and it seems to affect girls more than boys. Within the same family, it is common for only one child in a pair of twins or only one child within the same family to have the disease. Asians and African Americans are affected more frequently than Caucasians. Symptoms appear or develop about two to eight weeks after birth. Cells within the liver produce liquid called bile which helps to digest fat. It also carries waste products from the liver to the intestines for removal from the body. This network of channels and ducts is called the biliary system. When a baby has biliary atresia, bile flow from the liver to the gallbladder is blocked. This causes the bile to be trapped inside the liver, and it quickly causes damage, and scarring of the liver cells (cirrhosis), and eventually liver failure. Biliary atresia in children may occur because the bile ducts did not form properly during pregnancy. For other children, the bile ducts may be damaged by the body’s immune system in response to a viral infection acquired after birth. Biliary atresia is treated by a Kasai procedure (also known as a or hepatoportoenterostomy) to re-establish bile flow from the liver into the intestine. The surgeon removes the damaged ducts outside of the liver (called extrahepatic ducts) and identifies smaller ducts that are still open and draining bile. The surgeon then attaches a loop of intestine to this portion of the liver, so that bile can flow directly from the remaining healthy bile ducts into the intestine.

(Source: https://www.cincinnatichildrens.org/health/b/biliary)

LIVING LIVER DONOR TRANSPLANTS IN CHILDREN AND BABIES: In 15-40 percent of patients the Kasai procedure does not work. Of infants who have had a Kasai procedure, half still require liver transplantation before age five. A liver transplant operation removes the damaged liver and it is replaced with a new liver from a donor. Survival after surgery has increased dramatically in recent years and children with biliary atresia are now surviving well into adulthood. Improvements in transplant surgery have led to a greater availability of livers for transplantation in children. In the past, only livers from small children were deemed a suitable match for a transplant. Today, advances in treatment allow the option of “reduced size” or “split liver” transplants, with a piece of an adult liver for transplantation in a child with biliary atresia. Parents or relatives of children with biliary atresia may now be considered potential donors. Because healthy liver tissue regenerates quickly, the living donor and the child can expect their livers to grow back over time.

(Source: https://www.cincinnatichildrens.org/health/b/biliary, https://transplantsurgery.ucsf.edu/conditions–procedures/biliary-atresia.aspx)

FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:

MARI ABRAMS

MARI.ABRAMS@HEALTHONECARES.COM

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

Doctor Q and A

Read the entire Doctor Q&A for Thomas Heffron, MD, Pediatric Liver Surgeon

Read the entire Q&A