Information about liver transplant for children, including PELD scores, pediatric centers, and childhood-specific concerns
PELD (Pediatric End-Stage Liver Disease) is the scoring system used for children under 18, similar to MELD for adults. It includes bilirubin, INR, albumin, and growth failure (height/weight below normal). Higher PELD scores indicate greater urgency. Unlike MELD (max 40), PELD scores can exceed 40.
Common causes include: biliary atresia (most common in infants), metabolic diseases (like Alagille syndrome, Wilson's disease), acute liver failure, autoimmune hepatitis, primary sclerosing cholangitis, and liver tumors. Many children have congenital conditions present at birth.
Yes, split liver transplantation allows one adult donor liver to be divided and transplanted into two recipients (typically one adult and one child, or two children). This increases the supply of organs for pediatric patients. Reduced-size liver transplants are also possible.
Pediatric liver transplant volume varies significantly by center. Some centers perform dozens of pediatric transplants yearly while others do fewer. Higher volume centers often have better outcomes. Our Data Assistant can help you find pediatric transplant volumes.
Pediatric liver transplant survival rates are generally excellent. One-year survival rates for children exceed 90% at most centers. Long-term survival is also good, with many children living decades post-transplant. Outcomes have improved significantly over time.
Pediatric patients often have shorter wait times than adults because there are fewer children on the waiting list and organs can be split. However, wait time varies by blood type, size, and medical urgency. Some children receive transplants quickly while others wait longer.
PELD is used for patients under 18. Once a patient turns 18, they transition to the adult system and MELD scoring. This transition requires careful planning and coordination between pediatric and adult transplant teams to ensure continuity of care.
Yes, living donor liver transplantation is an option for children. A parent or relative can donate a portion of their liver to the child. This can reduce wait time and provides a scheduled surgery. The donor must be healthy and compatible in size and blood type.
Children can thrive after transplant, but require lifelong immunosuppression and monitoring. Effects may include growth catch-up (though some height limitation is common), normal development, school attendance with accommodations, and management of medication side effects.
Not all transplant centers perform pediatric transplants. Look for centers with dedicated pediatric programs, pediatric surgeons, and child life specialists. Consider location (you'll need to travel), volume, and your child's specific needs. Our Data Assistant can help identify pediatric centers.
Biliary atresia is a condition in infants where bile ducts are blocked or absent, causing bile buildup and liver damage. It's the most common cause of pediatric liver transplant. Treatment includes the Kasai procedure (surgery to restore bile flow), but many children eventually need transplant.
Support includes: child life specialists, social workers, support groups for parents, camps for transplant children, financial assistance programs, and educational resources. Many centers have dedicated pediatric transplant coordinators to help families navigate the process.
Growth failure is factored into PELD calculations - children below normal height/weight percentiles receive higher PELD scores. This reflects that growth failure indicates more severe disease. Nutritional support before transplant is important to optimize outcomes.