Pediatric Liver Transplantation

Clinical Programs

Pediatric liver transplantation has been an actively growing program at UNC. Since 1992, more than 78 pediatric patients under age 18 (range: 5.5 months – 18 years) have been successfully transplanted. Their diagnoses have included: biliary atresia, fulminant hepatic failure, alpha-1 antitrypsin deficiency, autoimmune hepatitis, primary sclerosing cholangitis, hepatitis C, cystic fibrosis, progressive familial intraphepatic cholestasis (PFIC), and Alagille’s syndrome.

Many advances in the field of pediatric liver transplantation have occurred in the last decade, including immunosuppressive management, expanded donor pools, and living-related/donor liver transplantation.

Clinical Outcomes

Since 1992, patient survival has been 92% and 89% at 1 and 3 years respectively with associated graft survival of 87.5% and 84.8% at 1 and 3 years respectively. These clinical results have been better than expected when compared with results from pediatric liver transplant centers around the U.S. (81% at one year and 76% at 5 years [Clinical Transplants, 1997]). State-of-the-art interventional radiology support has also allowed us to successfully correct vascular problems and bile duct narrowing, which historically are the “Archilles’ heel” of pediatric liver transplantation.

Program Accomplishments

After establishing our pediatric liver transplant program, we have enhanced our multi-disciplinary program by developing an active living-related liver transplant program. Donors for our patients have been parents of our patients, but they can also include other adults both related and unrelated.

To date we have successfully performed more than 15 living-related transplants (10 during the past 12 months). We now have the largest living-related donor liver programs in the Carolinas. Living-related donors allow the surgery to be performed semi-electively, and few patients die while waiting on the transplant list.

UNC Pediatric Liver Transplant Team

We have a team of dedicated physicians and surgeons (including the transplant surgeons, pediatric liver specialists, pediatric gastroenterologists, and pediatric infectious disease specialists), nurses, dieticians, social workers, teachers, psychologists, pharmacists and support staff. The team’s goal is to provide the best possible pre- and post-transplant care for those children requiring liver transplantation.

Members of the UNC pediatric transplant team include the following:

Division of Transplant Surgery:

Dr. Ken Andreoni
Dr. David Gerber

Division of Pediatric Gastroenterology:
Dr. Katherine Freeman
Dr. Steven Lichtman (Division Chief, Pediatric Gastroenterology)
Dr. Leena Kandula  (Assistant Professor of Pediatrics)
Dr. Ajay Gulati (Assistant Professor of Pediatrics)
Dr. Michael Kappelman (Assistant Professor of Pediatrics)

The team also includes dieticians and psychologists.