University Hospitals Geneva (HUG) and their affiliated Children’s Hospital are recognised as the national centre providing care for children suffering from a liver disorder – like your child. We are here to find a diagnosis, propose state-of-the-art treatments and guide you in caring for your child. We work as a team, and you are part of that team, as are your child’s other medical caregivers.

This site will provide you with information on some of the liver disorders in children. You will learn what is meant by “liver transplant” and what it involves for your child and for you, and you will become acquainted with the main people you are going to meet in our establishment. You will also find practical information to help you with your arrival and accommodation in Geneva, a list of frequently asked questions (FAQ), a glossary, a German-French dictionary and testimonials.

Liver diseases


Liver diseases in children are diverse. Unlike in adults, they are not linked to living habits, but in most cases are related to a congenital problem. The following is an overview of the most common diseases. It is important to know that all liver diseases in children are rare; so if your child’s disease does not appear on the list below, it is because we have focussed on the most common diseases.

For the sake of simplicity and easier reading, the masculine form is used for persons.

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Pre-transplant evaluation


Great progress has been achieved in organ transplantations: liver, kidney, heart, lung, and pancreas can be transplanted today. Here, we are only talking about the liver.

We would like to explain to you what a liver transplant is and give you explanations and useful advice regarding the hospital stays – before, during and after the intervention, as well as your return home.

You will then be well informed and thus able to take part in your child’s treatment in close cooperation with the medical and nursing team. Your involvement is decisive for the development and the proper functioning of the transplanted liver!

For the sake of simplicity and easier reading, the masculine form is used for persons.

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Waiting for a transplant


While waiting for the transplant, your child will be placed on a “waiting list”. This time is important for you and your child and it is absolutely necessary that each of the following points is followed up or observed strictly.



During this waiting time, it is essential that your child stays in the best possible form, maintains a good nutritional condition and does not develop any infections.

All these points will be discussed with you during the week of evaluation.

The transplant team will draw up a plan intended to meet your child’s health needs best. It is very important and it is your responsibility to make sure that the medical treatment plan of your child is observed. This plan includes instructions regarding drugs, diet, vaccinations and consultations. If, for whatever reason, you are not able to comply with these instructions, you must immediately inform the Centre.

The waiting period may last from some hours to several months. During this time, we will stay in contact with you and will regularly see your child.

As soon as your child is on the waiting list, you, the parents, will be the most important members of the transplant team. We depend on you to ensure the best possible healthcare for your child. It is important and it is your responsibility to keep us informed of any change in your child’s state of health.

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The graft



From the moment when we call you to announce you that we have a graft for your child, you will have about 1-3 hours to make preparations.

We recommend, however, having a small suitcase ready for you and your child so that the departure is as calm as possible. The graft coordinator will see to all details regarding your urgent trip to Geneva on the day of the graft, you do not need to organise anything. When you live far from Geneva, the coordinator will contact the REGA team to organise the transport by helicopter – depending on the weather.

From this call on, your child must fast (for the anaesthesia).

When a problem occurs at any point in time while waiting, please contact the Centre.

When your child arrives at our Centre, he will be examined by a physician on service and prepared by the nurses. This preparation takes place on the paediatric surgical ward that you already know. In general, your child will undergo an electrocardiogram (ECG), chest x-ray radiography, a blood collection with insertion of a catheter (intravenous line), examinations of urine, a bath and he must take 2 drugs.

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Post-transplant drugs



  • Take the drugs every day at the same time in order to avoid missing a dose. Use a weekly pill box to help you.
  • Do not try to “make up for” missed doses unless your transplant physician told you to.
  • Check the expiry date on the labels of all drugs.
  • For the drugs in vials, always check the dosage (mg/ml) and shake the vial before taking the desired quantity.
  • When you have to renew the drugs, inform your physician between five and seven days before running out of them. When you have a renewable prescription, it is sufficient to call your chemist’s.
  • In case of vomiting, apply the half an hour rule: when a vomiting episode occurred within haft an hour after the administration of the drug, it is reasonable to think that the child did not absorb his dose; thus, you can give him the same dose a second time. When the episode happens half an hour or more after the administration of the drug, do not administer it again, since it probably has been absorbed. Do not hesitate to contact our Centre when you are in doubt or if the vomiting persists.
  • Always give your child the exact quantity of the drug ordered by your physician. Do not follow the instructions on the vial, because they are frequently modified. Caution: 1 mg IS NOT EQUAL TO 1 ml!
  • Do not take any drug other than those that we prescribed for you without having consulted your transplant physician first.


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Nutrition and Hygene



It is very important to have a good nutritional state before and after a liver transplant. A good nutrition or the improvement of the nutritional state before a liver transplant may promote recovery and healing after the graft. A good nutrition may also improve the general state of health.

The transplant team’s dietician is available to give advice with respect to nutrition. He can make recommendations to improve and maintain your child’s nutritional state. The dietician may ensure that your child sticks to a diet appropriate to his age and comprising a large variety of food items of all food groups (starches, vegetables, fruit, milk and meat). He can also help your child when he is fed by tube and/or intravenously. Our team of dieticians know the subtleties of the needs of children with liver disorders very well.

The drugs that your child must take to prevent rejection after a liver transplant increase the risk of developing diseases such as diabetes, hypertension and cardiopathies and may cause excessive weight gains or losses. The dietician may give instructions and written information to reduce the risk of these complications.



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Back home


Back home, your child will no longer wear a mask to go to areas with a high density of people. However, for 6 months after the graft, it is preferable to avoid going to public places with a high density of people and in particular in winter. We recommend as well avoiding “physical” contact between your transplanted child and his brothers or sisters when the latter are sick. He may again drink tap water and you no longer need to sterilise pacifiers and soothers as well as nursing bottles.

After your return home, you will have appointments with your attending physician and at the Swiss Centre for Liver Diseases in Children. A blood sample of your child will be taken at every follow-up visit. At the Centre, we will also perform a follow-up ultrasonography and we will carry out urinary analyses to check the kidney function. Sometimes, we have to perform a liver biopsy.

During these consultations at the Centre, we must:

  • verify that the drugs are well adjusted to the state of health of your child and to the function of his liver, adjust the drug doses accordingly, discontinue certain drugs and add others.
  • make sure that your child does not develop a rejection of the liver. Contrary to what you think, rejection does not manifest by an acute accident. It manifests by a change in the laboratory examinations, by slightly elevated temperature or by a mild discomfort. In case of rejection, we must increase the doses of certain drugs or give others.
  • check the function of the kidneys. Some drugs may alter this function temporarily.
  • check the drugs for blood pressure.
  • make sure that no infection is affecting your child.
  • progressively diminish his drugs to a minimum.
  • make sure that the transplanted liver works perfectly.

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Swisstransplant is the Swiss national organism responsible for organ donation. Swisstransplant keeps a national list of transplants and establishes a connection between the persons who need a transplant and the organ donors. When the necessity of transplant is approved for your child, he is put on the waiting list managed by Swisstransplant. The official website of Swisstransplant is:

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When to call the center


It is very important that you inform the transplant Centre when one of the following pathological conditions occurs:

  • Fever exceeding 38°C for several days.
  • Vomiting for more than 12 hours or occurring less than half an hour after the administration of drugs.
  • Diarrhoea or watery stools for more than 12 hours.
  • Persisting expectoration or nasal discharge.
  • Redness around the scar or discharge from the scar.
  •  Shortness of breath, respiratory difficulty or excessive tiredness.
  •  Persisting or severe headache.
  • Increased or decreased blood pressure. Follow the instructions given by your transplant internist.


NOTE: Take your child’s blood pressure before giving him an anti-hypertensive drug. Record your child’s blood pressure readings in writing.

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Routine healthcare



When your child has not been vaccinated before the graft, the proposed vaccination schedule must be implemented as soon as our infectiologists recommend, in general 12 months after the graft. If possible, all family members must get a vaccination against varicella before the child undergoes the transplant. In case of an outbreak of measles or varicella in your region, please contact the Centre.

It is recommended that the vaccine series against pneumococcus, hepatitis A and hepatitis B be administered to your child before the graft. If he has not been vaccinated against hepatitis A or B, discuss this point with the internal specialist and your paediatrician to plan a vaccination schedule. The levels of antibodies against hepatitis A and hepatitis B will be checked annually. The annual vaccination against influenza is also recommended for the whole family.


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The Team   During the evaluation, you will meet many members of the liver transplant team. Every member has a special task to perform during the evaluation process, at the moment of the graft and afterwards. The persons who you will

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