Swisstransplant

 

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: www.swisstransplant.org

 

THE DONOR

The liver transplant is performed using the liver of a patient who is in a state of coma dépassé (cerebral death). This patient is the “organ donor” and your child becomes the “recipient”. Since very few children sustain cerebral death in our country, we often have to take a portion of the liver of an adult or of an older child in order to give it to your own child. In this case, the other portion of the donor’s liver can be transplanted to another recipient. Thus, two lives can be saved.

When a family decides to give the organs of a dear person who has been declared brain-dead, Swisstransplant starts an evaluation procedure of the organs likely to be transplanted. The donor’s medical history is examined and blood analyses are carried out in order to verify the good functioning of the organs as well as to detect a possible presence of hepatitis, HIV virus or other viruses. Based on this information, our transplant team will determine whether the organ is acceptable or not for transplantation. The surgeon who removes the organ will examine the liver to make sure that there is no visible anomaly. He may also take a small sample of hepatic tissue (a biopsy) for a detailed examination under the microscope. Despite all these precautions, there is still a very small risk that the liver does not work as it should after the transplantation (called “primary non-function”). When this happens, your child must undergo a second transplantation as soon as possible.

Normally, the donor’s blood type corresponds to your child’s blood type (except for type 0 which can be given to all recipients). Whereas type 0 is the universal donor, type AB is the universal recipient, that means that a child who has the blood type AB can receive a liver from an A, B, AB or 0 donor . When the transplant must be performed urgently, the medico-surgical team may accept a liver of a blood type different from that of your child (for a child who does not have type AB) or from the group 0; in this case, the blood type is “not compatible”. Recent data from literature suggest that the necessity to use a liver of a “not compatible” blood type does not constitute an increased risk for the recipient. When the surgeon and the hepatologist choose this option, they will inform you and explain their reasons to you.

In order to protect the anonymity of the donor’s family, we will not give you any information regarding your donor. When you or your family wish so, you can write a thank-you letter and/or your child can draw a picture for the donor’s family – to be sent via Swisstransplant. Please do not state your last name or any other personal data and do not enclose a photo. Place the letter in the hands of the referral nurse for children with liver disorders or liver transplanted children who will make sure that it reaches the donor’s family.

Sometimes, it is also possible to perform a liver transplant from a living donor. In this case, it often is a member of the child’s family who donates a portion of his liver. We discuss this possibility during pre-transplant evaluation, but we generally prefer to transplant the (portion of the) liver of a diseased donor because of the risk involved for the living donor and the psychological impact on the family.

 

ORGAN DISTRIBUTION

When Swisstransplant has a liver from a donor, they assign it to a patient waiting for a transplant on the national list: priority is given to patients who need it most urgently. A patient’s priority level is determined by several factors such as his degree of medical urgency, his blood type and his height. The size of the donor’s liver must be adapted to that of the recipient. A child can receive the liver of another child or a portion of the liver of an adult. In the latter case, the other portion of the liver can be given to an adult. Thus, the donor’s liver is given to two sick persons. The assignment of organs is made according to the MELD score and is governed by the Swiss Organ Transplant Act.

 

Swisstransplant – Who can people affected by organ transplantation contact?