The liver transplant

There is a liver available for your child. You have received a phone call from the Center informing you that there is a liver available for your child.

Don’t worry about anything. All details regarding your urgent trip to Geneva on the day of the transplant will be completely arranged by the transplant coordinator. If you live far from Geneva, this coordinator will be the one who will contact the REGA team to arrange for transport in a helicopter, depending on the weather.

After you receive the call from the Center informing you about the availability of a liver, make sure your child does not eat anything (empty stomach for anesthesia) and follow any instructions given to you by the medical team. Most importantly, please feel free to contact the Center if you have any questions or problems.

The team at the Center will be waiting for you and will welcome you. Your child will be placed in a room in the Pediatric Surgery Division that you are already familiar with. The nursing staff will do the final tests prior to the transplant (drawing blood, X-ray of the thorax, etc.).

Between your arrival at the hospital and the preparation of your child, another surgical team (the organ removal team) will examine and remove the liver of the donor. They remain in constant contact with the Center team that is taking care of your child. In very rare cases, the transplant is canceled because of an unexpected liver defect or a problem during removal. 

You can go with your child up to the entry door of the operating room. The anesthetist will greet you and then take your child to the operating room.

The operation itself will take between 6 and 10 hours. However, your child will usually stay in the operating room between 10 to 14 hours because of the preparation time.

First, your child's liver is removed from the abdomen. Then the transplant (new liver) is put in place. Your child's blood vessels are connected to the blood vessels of the donor's liver (vascular anastomoses). The surgeons then suture the bile duct of the new liver to a loop of your child’s intestine to allow drainage of the bile (bilio-digestive anastomosis).

At the end of the operation, a transparent dressing is placed, to make it easy to monitor the scar. The invisible threads used to close the wound stet on their own. 

To prevent unnecessary suffering, your child will remain asleep under anesthesia and artificial respiration. The duration of this artificial sleep will vary based on the progress of your child’s status.

Your child will be monitored in Intensive Care for a few days (around 4 to 5 days), and will then be admitted to the Pediatric Surgery Division for about three weeks. The length of stay may vary depending on your child’s recovery. Various exams are carried out to assure that the transplant is progressing satisfactorily. They are first carried out every day, and then at longer and longer intervals. During this period, the post-transplant treatments are adjusted and the team will explain how to give the medication to your child once you are back at home.

You will be able to learn everything gradually and the team will be there to guide you and to answer all your questions.