Waiting for a Donor Liver for Your Child

Step Two: Waiting for a Donor Liver

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Once your child is approved for a liver transplant and added to the transplant waitlist, we begin the process of finding a donor liver. They may have the option of receiving a liver from a living donor or a deceased donor from the national waitlist. Our goal is to offer your child the healthiest liver possible with minimal wait time.

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Options for Liver Transplant

Our experienced pediatric transplant team performs several types of liver transplants -- including both deceased and living donor transplants. We are one of the few pediatric programs in the country to offer split transplants. These options create more opportunities for more children to receive a healthy donor organ.

Deceased Donor Transplant

In a deceased donor transplant, the liver comes from someone who has passed away. For this type of transplant, your child’s name will be added to the United Network of Organ Sharing (UNOS) waitlist. UNOS is the organization that matches donated organs to recipients based on criteria such as blood type, body size, and severity of disease.

Living Donor Transplant

In a living donor transplant, part of a liver comes from a living person. This can be a relative, a friend, or a stranger. Living donors, must be 18 or older, and must complete a medical evaluation to make sure they are in good health before they can safely donate part of their liver. The recipient’s and the donor’s partial livers grow to full volume about three months after surgery.

Split Liver Transplant

In a split liver transplant -- also called a partial graft -- a liver from a deceased donor is divided between two recipients. The right lobe can be transplanted into most adults, and the left lobe, which is smaller, can be transplanted into an infant or child. The partial grafts grow to normal size after transplant. Split liver transplants can save two lives with one donor organ and shorten time on the national waitlist. To receive a split liver transplant from a deceased donor, your child will be placed on the UNOS waitlist.

The Waitlist

UNOS matches donor organs to recipients according to several factors including blood type, body size, geography, and the severity of their liver disease. Your child’s degree of illness is determined by a score that is calculated using  blood work results. For children younger than 12, this is called a PELD (pediatric end-stage liver disease) score. A MELD (model for end-stage liver disease) score is used for people 12 and older. 

Our Locations

Liver transplant surgery is performed at Duke Children's Hospital and Health Center. Pre- and post-transplant appointments take place at our liver transplant clinic within Duke Children's.

Support While You Wait

Waiting for a transplant can be stressful and frustrating, but our team is always available for support. Your child will be seen by the transplant team on a regular basis to make sure they are healthy enough to undergo a transplant when a liver becomes available. Our dietitians, doctors, social workers, and others will guide you in providing good nutrition and appropriate activities for your child while they wait for a donor. 

Is Your Child Ready for an Evaluation?

If you want to make an appointment for a pediatric liver transplant evaluation for your child, contact us. Our team can help with next steps.

24/7 Health Care Access

Throughout the transplant journey, a transplant coordinator is available around the clock to address any questions or concerns that arise. In addition, a pediatric liver transplant specialist and a transplant surgeon are on call 24 hours a day, 365 days a year to respond to your child’s medical needs.


Step 3: Transplant Surgery

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

This page was medically reviewed on 09/01/2023 by