Research and Clinical Trials
Liver Transplant Research and Clinical Studies
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. Evelyn Hsu, medical director of Seattle Children's Gastroenterology and Hepatology Program and Liver and Intestine Transplant Program is the vice president of the Society of Pediatric Liver Transplantation (SPLIT).
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.
Society for Pediatric Liver Transplantation (SPLIT)
Dr. Evelyn Hsu is the Council Vice President of the Society of Pediatric Liver Transplantation (SPLIT). SPLIT's mission is to improve the outcomes in children receiving liver transplantation through research, quality improvement, education, training, mentorship and patient advocacy. As of 2021, SPLIT is made up of over 40 pediatric liver transplant centers from the United States and Canada, as well as sites from Australia, India and Saudi Arabia.