Before the transplant

Your child has liver disease that requires a liver (hepatic) transplantation. We recommend that you consult these pages before the pre-transplant assessment week in order to prepare yourself and to get a better understanding of what is involved and how these various exams will take place.

This is an opportunity to introduce you to the Swiss Children's Liver Center so that you can get to know how it works. Liver transplant and preparing for one will be explained to you. 

The purpose of the pre-transplant assessment is to evaluate  your child's overall condition by taking into account their personality, interests, interactions within the family, at school, etc. By getting to know your child, we will be able to establish a personalized protocol.

The assessment lasts about a week and includes several interviews with various participants, a nutritional assessment, a psychological evaluation, blood tests, and ultrasound examinations. Depending on the situation, the assessment will also include a liver biopsy, a CT scan, an MRI or a digestive endoscopy. 
These four exams are performed under general anesthesia.

In spite of these onerous and inconvenient elements, this week will allow you to get acquainted with the Center, the division, the nurses and the doctors with whom you will have several interviews. The medical care team will inform you about the exam results. Please feel free to ask any questions or to share your concerns with them.

These are the most common exams :

• Blood tests and urinalyses (clickable link): to see how your child’s liver, kidneys and other organs function. 
• Electrocardiogram (ECG) echocardiograms: pain-free exams to evaluate your child’s cardiac activity.
• Ultrasound scans or abdominal ultrasound scans: pain-free exams to evaluate the size of your child’s liver and blood vessels.
• CT scans or MRIs: exams that are carried out under general anesthesia in order to obtain a better view of your child’s anatomy in 2 or 3D.
• Liver biopsy or liver biopsy puncture: removal of a fragment of the liver that is carried out under general anesthesia for analysis under the microscope.
• Digestive endoscopy: an exam using a small camera carried out under general anesthesia to view the interior of the esophagus, the stomach and the first part of the intestine.
• Psychological assessment: this is offered to parents before their child is placed on the transplant list. This assessment allows the Center's psychologist to meet the children and their families who are included in the liver transplant program. The purpose of this first consultation is to comprehensively evaluate how the family and the individual functions. This interview makes it possible to highlight the resources the child and their family have as well as any potential vulnerabilities in order to offer appropriate psychological support throughout the treatment process.

Before an operation, a few sessions of hypnosis allow you to release your fears or phobias related to care (fears of injections, anaesthesia, surgery, etc.) and to better prepare yourself for what life will be like "after"... for example after a transplant.

When an intervention is planned sufficiently in advance, hypnosis sessions are an opportunity to teach self-hypnosis to the child, so that he learns to modify his sensations himself... before, during and after his hospital stay.

We determine the indication for a transplant for your child. Depending on your child’s illness and its severity, the waiting time will vary and can last from a few days, to several months, or even one or two years. Throughout this period, you willstay in touch with the Center, which will  answer  all your questions and ensure, in partnership with you, the well-being of your child. 

The transplant team will establish a personalized program with your cooperation to best meet the health needs of your child. This will serve as your guide throughout the waiting period, providing you with information about medication, nutrition, vaccinations and medical care.

Your child must be protected against infections. Because certain vaccines cannot be administered after transplantation, they are sometimes administered ahead of the usual vaccine schedule. All indications concerning these changes will be given to you and your child’s pediatrician during the assessment week.

A good diet is essential for your child's development and continued good health. To meet your child’s special needs, a dietitian will advise you and help you to adapt his/her diet based on tastes and preferences. The goal is to maintain the proper growth of your child. 

To minimize the risk of infection, your child’s teeth must be in perfect condition. Therefore, your child’s teeth should be checked by your dentist.

Do not hesitate to contact your attending physician and the Center if you notice changes in your child's behavior, a decrease in appetite and changes in bowel movements, or even if it only seems like the child is not doing as well as usual.

Below is a list of situations in which you should call a doctor who knows your child : 

• Temperature equal to or greater than 38°
• Forceful or repetitive vomiting
• Vomiting of blood
• Bloody or black stools
• Loss of appetite
• Abdominal swelling
• Respiratory difficulties
• Increased yellow color of the skin.

You must also contact us immediately if your child :

• Comes in direct contact with a person with chicken pox
• Is hospitalized
• Must take new medication or change their diet.

Your child will undergo regular monitoring at the Center to prepare properly for the transplant. These visits make it possible for you to maintain a connection with the team and to get all of your questions answered. Each consultation is an opportunity to assess the health status of your child and organize the care in collaboration with the child’s pediatrician or attending physician. 

At each appointment, please remember to bring a recent copy of the child’s vaccination records, a list of their medication with dosages, as well as information about their diet.

An organ may become available at any time and transplant must take place as soon as possible. This is why you need to be reachable 24 hours a day.

• Please give your cell phone number to the Center
• Always keep your phone with you 
• Check that the network is working properly
• Save the Center phone number so you can reach us at any time 
• Report any changes to your number to the transplant coordinator
• Do not leave Switzerland, unless it is near the border for brief periods of time, and not farther than an hour away by car.

If you have any questions or phone changes to inform us of, please contact us at  +41 22 372 46 60 or by email : foieped@hcuge.ch.  

To avoid the stress of driving your child to the Center. If you live far away, we strongly advise you to register.

You will be transported with your child on the day of the transplant or before if an emergency transfer is necessary. However, please note that only one parent is allowed in the helicopter.

From the moment the Center informs you of the arrival of a liver donor for your child, you will have around 1 to 3 hours to prepare. This is why we recommend keeping a small suitcase ready for you and your child during the waiting period so that you can depart as calmly as possible.