Paediatric Liver Transplant Waiting List

Written by Hexahealth Care Team, last updated on 11 July 2023
Paediatric Liver Transplant Waiting List

Children with acute liver failure or end-stage liver disease may benefit from a paediatric liver transplant. A healthy liver from a deceased donor or living is used to replace a damaged liver. This treatment is crucial not just to improve life expectancy but also to improve their overall quality of life.

Complete knowledge about transplants, including the paediatric liver transplantation waiting list, is essential. One also needs to fully understand what must be done for the transplant to be successful. 

What is a Paediatric Liver Transplant?

A paediatric liver transplant is a surgical procedure where a diseased or malfunctioning liver is replaced with a healthy liver from a donor. It is performed to treat severe liver diseases that cannot be managed with other treatments. 

The new liver takes over the functions of the damaged liver, allowing the child to live a healthier life. Paediatric liver transplants have the potential to save and improve the lives of children with life-threatening liver conditions. 

The surgery takes about 8 hours. The success of the transplant depends on factors such as the compatibility of the donor and recipient, post-transplant care, and the child's overall health.

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Need for Paediatric Liver Transplant

The case of every child is different. A multidisciplinary team of medical experts determines the requirements for a paediatric liver transplant eligibility criteria.
In most cases, a liver transplant is needed by the following.

  1. Severe Liver Disease: Paediatric liver transplants are necessary when a child has a severe liver disease that cannot be effectively managed with medication or other treatments.

  2. Acute Liver Failure: In some situations, infections, drug interactions, or other unknown factors can cause liver failure.

  3. Chronic Liver Disease: This causes long-term liver damage and may require liver transplantation.
    Examples of such chronic illnesses include primary sclerosing cholangitis, autoimmune hepatitis, and progressive liver fibrosis.

  4. Alagille Syndrome: A hereditary condition that frequently affects the liver (among other organs), resulting in the failure or narrowing of the bile ducts.

  5. Child-specific Sclerosing Cholangitis: When the bile ducts become constricted due to inflammation and scarring, it causes liver damage.

  6. Tumours: Large tumours that can only be treated by removing the entire liver from certain children require liver transplantation.

In India, a yearly paediatric liver transplant from dead donors meets the demand for about 500 kids. For the previous 20 years, this figure has stayed the same.
Adult liver transplantation rates, on the other hand, are more than ten times higher and are increasing at a rate of 10% annually.

Paediatric Liver Transplant Evaluation Process

Once the patient has finalised the transplant centre, they must undergo certain evaluations to ensure they follow the eligibility criteria.
However, one must know that the evaluation criteria will vary from one healthcare facility to another.
The primary purpose of the evaluation process includes:

  1. If a person is healthy enough to handle the transplant and the lifelong post-transplant medications.

  2. Finding out about existing medical conditions and their impact on the transplant.

  3. Are willing to follow the essential guidelines and other follow-ups.

The Evaluation Process Consists of:

  1. Overall health checkup

  2. Laboratory and imaging tests 

  3. Psychological Evaluations 

  4. Introduction with the support and care services 

  5. Nutrition counselling 

  6. Financial counselling

Paediatric Liver Transplant Waiting List

The paediatric liver transplant waiting list, maintained by transplant centres, contains information about children who require liver transplants. The list is managed using a grading system like the Paediatric End-Stage Liver Disease (PELD) or Model for End-Stage Liver Disease (MELD). 

These algorithms rank candidates based on necessity and evaluate the seriousness of a child's ailment.
When there is a liver transplant waitlist for kids, it indicates that their condition is severe and that a transplant is their last remaining hope of survival.

Paediatric Liver Transplant Waiting Period

While it is difficult to accurately comprehend when your child will hit the jackpot with the paediatric organ transplant waiting list, you must always be ready and follow the proper set of protocols. These include: 

  1. Always stay in touch with the healthcare providers and keep them updated about the current health conditions of the child.

  2. Ensure your child is eating right and in the best health.

  3. Regularly attend the medical appointment and keep the child away from all possible infections. 

The liver transplant waiting time for children highly depends upon multiple factors.
They will be considered for transplants only when the child meets the paediatric liver transplant eligibility criteria. 

Always inform the coordinator if your child has recently had chicken pox, the flu, a fever, or any other contagious illness.
If there are any problems, the coordinator for the liver transplant will consult with the transplant physicians.

After Liver Allocation

When the liver has been allocated to the patient, it is essential that they can reach the hospital within 6 hours.
After a suitable liver becomes available for transplantation, it is allocated to the most appropriate recipient based on factors such as blood type, body size, and medical urgency.

The criteria are as follows:

  1. Transplant Evaluation: The transplant team thoroughly evaluates the recipient to ensure their overall health and readiness for the surgery. 

  2. Preoperative Preparations: The recipient undergoes preoperative preparations.
    It includes necessary medical tests, consultations, and discussions about the transplant procedure and post-transplant care.

After a Liver Transplant

Following a liver transplant, one can expect the following: 

  1. One must spend a few days in the intensive care unit.

  2. The patient's condition is closely monitored by doctors and nurses, who will look out for any issues.

  3. Additionally, they'll regularly evaluate the liver function for indications that the new liver is functioning.

  4. Stay in the hospital for five to ten days.

  5. One is moved to a transplant recovery area to continue recovery till they are stable.

Once discharged and back home, one keeps healing at home and has regular checkups. The transplant team creates a timetable for checkups. 

Blood tests could be administered a few times per week at first, then less frequently as time goes on. Following liver surgery, several drugs are prescribed.

Paediatric Liver Transplant Success Rate

Paediatric liver transplant patients have a 5-year survival rate of 85%. The quality of life and survival rates for young children with end-stage organ failure can be significantly increased by paediatric liver transplantation candidate selection. 

However, because there is frequently a shortage of appropriate organ donors, finding them remains a major difficulty.
This shortage serves as a reminder of the value of organ donation and the need for greater public understanding and support of organ donor programs.

Risks and Complications of Paediatric Liver Transplant

Even though the paediatric liver transplant is a successful surgery, certain risks and complications are bound to be associated with this procedure. These risks include: 

  1. Seizures or mental confusion

  2. Rejection of the new liver 

  3. Bleeding 

  4. Bile duct complications 

  5. Infections 

  6. Blood clots

  7. Failure of the new liver


The paediatric liver transplant waiting list is a crucial lifeline for children with end-stage liver disease or liver failure. It allows for prioritising and distributing appropriate donor livers to individuals in immediate need.
The length of the transplantation wait depends on the child's condition, the allocation method, and the availability of donor organs.

HexaHealth is a health and wellness platform that understands and acknowledges the many hurdles associated with poor health and problems.
As a team of experts, our utmost is to help you in the best ways possible and ensure that you are getting connected with the right people at the right time. To discover how we can help, log on to HexaHealth today. 

Suggested Reads

Top 10 Paediatric Liver Transplant Hospitals Types of Liver Transplant
Unknown Facts about Liver Transplant Surgery Liver Transplant Rejection
Liver Transplant Success Rate Financing Options for Liver Transplant in India
Best Liver Transplant Surgeon in India Health Insurance for Liver Transplant in India

Frequently Asked Questions

Is there a separate waiting list for paediatric liver transplants?

Yes, there is a separate waiting list for children requiring liver transplants. This distinct list acknowledges children's special medical and developmental needs and ensures they get the attention and care they need.

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How is the paediatric liver transplant waiting list managed?

Transplant facilities and medical professionals work together to control the waiting list for the paediatric liver transplant surgery process. It comprises : 

  1. Assessing and compiling a list of eligible children

  2. Prioritising according to the severity of the ailment

  3. Policies for allocating organs

  4. Routine monitoring

  5. Dialogue with families

  6. Improving pre-transplant care.

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What are the eligibility criteria for paediatric liver transplant?

A multidisciplinary transplant team evaluates each case on an individual basis. The eligibility for paediatric liver transplant outcomes is as follows: 

  1. The degree of liver disease

  2. The child's general health

  3. The lack of substantial comorbidities

  4. The likelihood of successful transplantation results

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How are paediatric liver transplant centres involved in the waiting list process?

Paediatric liver transplant allocation policy centres are crucial in the waiting list process. Their involvement includes : 

  1. They evaluate and assess children for transplant eligibility

  2. Maintain the waiting list

  3. Prioritise patients based on medical urgency

  4. Monitor their condition while on the list

  5. Coordinate organ allocation and transplantation surgeries.

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What factors determine a child's priority on the liver transplant queue?

The order in which a child is placed on the liver transplant waiting list depends on several variables. These factors include: 

  1. The child's medical necessity

  2.  The severity of their liver condition

  3. The possibility of successful paediatric liver transplantation complications

  4. Suitability with their blood type

  5. Size compatibility with available donor organs

  6. The length of time they have been on the transplant waiting list.

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What is the organ allocation process for paediatric liver transplantation?

An organised mechanism is used for the distribution of donor organs allocation the paediatric liver transplantation process to promote fairness and equity.
Typically, it adheres to standardised rules and regulations defined by regulatory agencies and transplant groups. These include: 

  1. Entry of the donor details.

  2. Informing the patients who are the sickest about organ availability.

  3. Evaluating the suitability and rejection of the organ.

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What is the average waiting time for children on the liver transplant waiting list?

The duration of time children spend on the waiting list management for paediatric transplants varies based on several variables. These include: 

  1. The number of suitable organ donors willing to donate

  2. How urgent the child's medical condition is

  3. The demand for paediatric livers in a given area.

Since waiting times vary greatly, it is difficult to give an exact average.

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Are there specific criteria or guidelines for children's liver transplant priority list?

Specific criteria and guidelines determine the priority of children's liver transplant waiting list. These criteria vary between transplant centres and may include factors such as: 

  1. The child's medical urgency

  2. The severity of liver disease

  3. Potential for successful transplantation outcomes

  4. Blood type compatibility

  5. Size matching with available donor organs.

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What are the statistics for the paediatric liver transplant waiting list?

There has been a significant rise in paediatric liver transplant waiting list statistics. From 2016 to the current date, there has been an increase of 54.5 % in the paediatric liver transplant waiting list.

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What are the outcomes of paediatric liver transplantation in terms of success rate?

Paediatric liver transplantation has a success rate of 85% over 5 years. The success rate of paediatric liver transplantation varies depending on several factors, including: 

  1. The child's underlying liver disease

  2. Overall health

  3. Compatibility of the donor organ

  4. Surgical expertise

  5. Post-transplant care

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What are the survival rates for children who undergo a liver transplant?

As per a study published in Indian paediatrics, the survival rates for children who undergo a liver transplant are about 95% at 1 year and about 70% at 5 years.
The paediatric liver transplant survival rates for children undergoing a liver transplant have significantly improved. Generally, paediatric liver transplantations have shown favourable outcomes, with high survival rates.

A paediatric liver transplant comprises a surgical procedure under which a diseased or damaged liver in a child is replaced with a healthy liver from a donor. The 8-12 hours process involves: 

  1. Putting the patient to sleep through general anaesthesia.

  2. Making an incision across the abdomen.

  3. Replacement of the damaged liver with a healthy liver.

  4. Removal of gallbladder

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What are the complications of paediatric liver transplantation?

The success rate of young liver transplants is high, and issues are frequently treatable with suitable medical attention. There are still some potential risks, which include: 

  1. Organ rejection

  2. Infection

  3. Bile duct troubles

  4. Surgical Concerns

  5. Immunosuppressant medication side effects

  6. Long-term complications like growth problems

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All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.

  1. Perito ER, Roll G, Dodge JL, Rhee S, Roberts JP. Split Liver Transplantation and Pediatric Waitlist Mortality in the United States. Transplantation. 2019 Mar;103(3):552–
  2. Condition Topics > Yale Medicine [Internet]. Yale Medicine. [cited 2023 Jul 11].link
  3. Philadelphia TCH of. Liver Transplant Waiting List [Internet]. 2014 [cited 2023 Jul 11].link
  4. Liver Transplant (for Parents) - Nemours KidsHealth [Internet].
  5. Redirect Notice [Internet]. [cited 2023 Jul 11].link

Updated on : 11 July 2023


About Authors

HexaHealth Care Team

HexaHealth Care Team brings you medical content covering many important conditions, procedures falling under different medical specialities. The content published is thoroughly reviewed by our panel of qualified doctors for its accuracy and relevance.

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