Years of research have led to innovative procedures that increase the chances for children to receive new livers – and live healthy lives. Survival rates for patients of Seattle Children’s Liver Transplant Program are among the best in the nation.

We use living donor transplants and split or reduced livers so we can offer transplants to more children who need one. We also are able to transplant children who do not have a donor match (ABO-incompatible liver transplants).

Our doctors are international leaders in improving care for children with liver failure. The same doctors who care for children needing liver transplants also do research to find better ways of treating your child before, during and after they receive a new organ. Seattle Children’s doctors lead multicenter research studies. We actively share information with other transplant centers to advance our treatments.

A major focus of our research is improving care for children after their transplant. We work to find better mixes of medicines to prevent organ rejection while keeping a child’s immune system strong enough. This helps children fight off infection and avoid other complications. Another area of research is finding early markers of cancer recurring after liver transplant. As we learn more, we hope to prevent cancer from returning or stop it in time to save the new liver from damage.

New Procedures Boost Children’s Chances for Transplants

Up to 40% of liver transplants at Seattle Children’s Transplant Center are done using newer techniques that make transplantation possible for more children.

Living donor liver transplants

In a living donor transplant, a child receives part of the liver from a living adult. The option of a living donor can shorten the waiting period for a donor organ.

Within a few weeks after surgery, both the donor’s liver and the part transplanted into the child grow back to full size. Children who are transplanted with living donor livers have a life expectancy as good as or better than with a deceased donor.

Split- and reduced-liver transplants

In a split-liver transplant, the donor liver is divided into two parts and transplanted into two recipients. Most often, the patients are an adult and a child. This makes the most use of a single donor liver.

In a reduced-liver transplant, surgeons transplant part of a deceased donor’s liver. This lets a child get a liver that fits properly.

Learn more about liver organ donation.

ABO-incompatible liver transplants

To save a critically ill child’s life when a compatible liver cannot be found in time, Seattle Children’s may perform an “ABO-incompatible” transplant. “ABO incompatible” means a patient is receiving a liver from a donor who is not a blood-type match. This is reserved for patients who are too sick to wait for a matched donor.

The child receives treatments to lower the number of existing antibodies that might damage the transplanted liver. For example, a child with type A blood normally has antibodies against type B blood. Without these treatments, the “anti-B” antibodies in the child with type A blood would damage a liver from a donor with type B blood.

The antibody-lowering treatments are only needed a few weeks before and after transplant. After that, the follow-up treatment is the same as for a child receiving a matched donor organ. Survival rates for children receiving ABO-incompatible livers at Seattle Children’s are similar to outcomes for children with a matched donor.

International Partnerships Improve Treatments

Our doctors have leadership roles in national and international groups that are setting standards and finding better treatments for children who need liver transplants.

For example, Dr. Simon Horslen, medical director of Seattle Children’s Liver and Intestinal Transplant Program, is past chair of the Pediatric Community of Practice of the American Society of Transplantation. He is a co-investigator in a large National Institutes of Health (NIH)–funded research group studying many aspects of liver disease in children.

To increase understanding, we collect and share information and blood samples from our patients. We are very careful to protect our patients’ identities.

It is entirely up to you whether to take part in research studies or share information about your child’s illness with researchers. Learn about participating in transplant research.

Studies of Pediatric Liver Transplantation (SPLIT)

Horslen also leads multicenter studies sponsored by Studies in Pediatric Liver Transplantation (SPLIT). The partnership includes more than 30 liver transplant centers in the United States and Canada. Horslen co-chairs the SPLIT Council.

SPLIT members share information to improve the survival and health of children who receive liver transplants. Current efforts are looking at best practices and sharing that information throughout the SPLIT community.

Pediatric Acute Liver Failure study group

Seattle Children’s is one of 12 academic hospitals in the Pediatric Acute Liver Failure (PALF) study group. Its goal is to get a more complete picture of this rare disease and to find better treatments.

Horslen leads our hospital’s participation in PALF multicenter studies. This program is funded by the NIH and the Food and Drug Administration (FDA).

Read more about research into liver disease at Seattle Children’s.

Diseases of the Liver in Children

To improve diagnosis and treatment of pediatric liver disease, two Seattle Children’s experts have written a textbook that provides a practical guide for primary care doctors and gastroenterologists in the community. Drs. Karen Murray and Simon Horslen are co-editors of Diseases of the Liver in Children.