Glowing liver symbols surrounding a child

Pediatric Liver Transplants: A Parent's Guide to Indications and Timing

Rhea Morgan in Health & Wellness November 2025 • 4 min read.

"Navigating the complexities of liver transplantation in children: What parents need to know about when and why it's considered."

Since the first successful pediatric liver transplant in 1963, survival rates have dramatically improved. This progress stems from advances in surgical techniques and medications, as well as a more comprehensive approach to care involving specialized transplant teams and efficient organ donation systems. What was once an insurmountable challenge for children with end-stage liver disease has now become a manageable condition with the potential for long-term survival.

In Korea, the first deceased donor liver transplant in a child was successfully performed in 1988, followed by the first living donor transplant in 1994. Since then, major hospitals have performed over 150 pediatric liver transplants, positioning the country as a leader in the field and a training hub for developing nations. This article will delve into the specific indications for liver transplantation in children and discuss the crucial considerations for determining the optimal timing of the procedure.

For parents facing the daunting prospect of a liver transplant for their child, understanding the process and the factors influencing its success is essential. This guide aims to provide clear, accessible information to help you navigate this challenging journey with confidence.

What Conditions Warrant a Liver Transplant for My Child?

Glowing liver symbols surrounding a child

Worldwide, the most common indication for pediatric liver transplantation is biliary atresia, a condition where the bile ducts outside and inside the liver are abnormally narrow, blocked, or absent. In the United States, metabolic disorders are the second most frequent reason for transplant. However, in Korea, due to the relatively low incidence of congenital metabolic disorders, fulminant hepatic failure (sudden, severe liver dysfunction) is the second leading indication.

Other conditions that may necessitate liver transplantation in children include:

Wilson's disease
Glycogen storage disease
Alagille syndrome
Liver tumors
Neonatal hepatitis
Idiopathic cirrhosis
Congenital hepatic fibrosis
Autoimmune hepatitis

A review of cases at Samsung Medical Center revealed that biliary atresia accounted for 65% of pediatric liver transplants, followed by fulminant hepatic failure (8%) and metabolic disorders (7%). Data from Asan Medical Center showed similar trends, with biliary atresia at 61%, fulminant hepatic failure at 15%, and metabolic disorders at 10%. These statistics highlight the prevalence of specific conditions and can help parents understand the relative likelihood of different diagnoses leading to a transplant.

Making Informed Decisions About Timing

The decision to proceed with a liver transplant is never easy. By understanding the indications, considering the timing, and maintaining open communication with your medical team, you can navigate this complex process with greater confidence and provide your child with the best possible chance for a healthy future.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.4285/jkstn.2011.25.3.151, Alternate LINK

Title: Indication Of Pediatric Liver Transplantation

Journal: The Journal of the Korean Society for Transplantation

Publisher: The Korean Society for Transplantation

Authors: Mi Jin Kim, Yon Ho Choe

Published: 2011-01-01

Everything You Need To Know

What are the primary conditions that might lead to a child needing a liver transplant?

The most common reason for pediatric liver transplants worldwide is biliary atresia, a condition where the bile ducts are abnormally narrow, blocked, or absent. In the United States, metabolic disorders are the second most frequent reason. In Korea, fulminant hepatic failure is the second leading indication due to the relatively low incidence of congenital metabolic disorders. Other conditions include Wilson's disease, Glycogen storage disease, Alagille syndrome, Liver tumors, Neonatal hepatitis, Idiopathic cirrhosis, Congenital hepatic fibrosis and Autoimmune hepatitis.

How have advancements in medicine improved the outcomes for children needing liver transplants?

The success of pediatric liver transplants has dramatically improved since the first successful procedure in 1963 due to advances in surgical techniques, improved medications, a comprehensive approach to care by specialized transplant teams, and more efficient organ donation systems. This progress has transformed what was once a nearly insurmountable challenge into a manageable condition with the potential for long-term survival.

What do statistics from medical centers reveal about the common causes of pediatric liver transplants?

Data from Samsung Medical Center revealed that biliary atresia accounted for 65% of pediatric liver transplants, followed by fulminant hepatic failure (8%) and metabolic disorders (7%). Asan Medical Center showed similar trends, with biliary atresia at 61%, fulminant hepatic failure at 15%, and metabolic disorders at 10%. While these statistics are specific to these medical centers, they highlight the prevalence of specific conditions that often lead to liver transplants.

Why is Korea considered a leader in the field of pediatric liver transplantation?

Korea has emerged as a leader in pediatric liver transplantation, performing the first deceased donor liver transplant in a child in 1988 and the first living donor transplant in 1994. Major hospitals in Korea have since performed over 150 pediatric liver transplants, establishing the country as a training hub for developing nations. This is likely because of a robust medical infrastructure, skilled surgeons, and a commitment to advancing transplant techniques.

What factors are considered when determining the right timing for a pediatric liver transplant?

Deciding on the timing of a liver transplant involves careful consideration of the specific condition, the child's overall health, and the availability of a suitable donor organ. Maintaining open communication with the medical team is crucial. The medical team will assess the severity and progression of the underlying liver disease and weigh the risks and benefits of transplantation against other possible treatments, such as medications and supportive care. They strive to determine the optimal point at which transplantation will offer the greatest chance of long-term survival and improved quality of life.