Types of liver transplant

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Types of liver transplant

In an effort to overcome the shortage of availability of livers, particularly in children, there are now a number of different types of liver transplant which can be carried out.

Why are there different types of transplant? There is a shortage of organs for transplantation. Fortunately a variety of techniques have been developed which increases the supply of organs for children's liver transplantation.

The liver is made up of eight segments each with its own blood supply and bile drainage. This means that it is possible to use part of the liver for transplantation and this will function and grow like a whole liver. Not every type of transplant is suitable for every patient.

What are the types of liver transplant?

Whole liver - in this type of transplant the liver is an appropriate size for the child and the whole liver is used.

Cut Down (Reduced Graft) - sometimes the donor liver is too large for the child. The surgeon reduces the size of the liver by removing some segments and transplanting the remainder. The cut surface is covered with special glue so that the blood vessels and bile ducts are sealed. The new piece of liver grows with the child

Split Liver - the liver can be split into two lobes with the right lobe being given to an adult or older patient and the left lobe to a child. As before, the cut surfaces are sealed.

The following types of transplant are currently only available at King's College Hospital, London.

Living Related Transplantation - in some cases it is possible for a relative (a parent) to give part of their liver to their child. The donor has to be carefully tested to see if they are suitable as this is not always the case.

Auxiliary Transplantation - in certain types of liver disease, particularly some metabolic diseases or in some cases of acute liver failure, part of a donor liver can be transplanted alongside the child's own liver. The transplanted liver is able to carry out the functions of the liver which are not performed by the child's own liver. Such an operation may be carried out where there is the possibility of the child's liver recovering, as can occur in some cases of acute liver failure.

Hepatocyte (cell) transplantation - a new and experimental procedure whereby liver cells are injected into the child’s liver with the aim that the donor cells will multiply and will increasingly correct the abnormality within the liver. This procedure is not possible in patients with a damaged (cirrhotic or fibrotic) liver. At present it is believed that hepatocyte transplantation may have a useful role in treating metabolic liver conditions and liver rescue in the future. A child undergoing hepatocyte transplant will need to take anti-rejection medicines for the rest of their life, as with all forms of transplantation. This procedure is very much at the frontier of knowledge.