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

Rhea Morgan in Health & Wellness April 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?

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.

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.