For what I do, for liver, intestine, kidney, if you’re a small child, you end up in the ICU. All the livers and intestines end up in the ICU for at least a day or two. If there’s good organ function, then the post-op course is going to be pretty smooth: they usually spend a few days in ICU, and then up to the floor for another week or two, and then home. But obviously, there is a high rate of complications in transplants, so whatever comes up, we deal with it as best we can.

Heung Bae Kim, MD, Surgical Director for Liver, Intestine, and Kidney Transplant Programs, Director of the Pediatric Transplant Center

 

What is the immediate recovery?
Every child is different (obviously if someone has chronic lung disease, this will not be the case) but typically most of our patients get extubated in the OR, so they won’t go with the breathing tube to the ICU. Usually it’s a day in the ICU for the liver transplants and a few days in the ICU for the multiviscerals. They then go to the Transplant Unit, and depending on their recovery, we’d hope the liver patient would be home within probably two weeks, and the multivisceral, I think we say around 40 days. It’s so dependent, it’s hard to extrapolate because multivicerals are such individual cases.

Rima Fawaz, MD, Medical Director, Multivisceral Transplant Program

 

How do you know when a family is ready to go home?
We have multidisciplinary meetings every afternoon. As a team, we’ll go over all patients, we go over the outpatients. We’re always in the loop, and it’s a small group of physicians that cover the service, so we know them very well. We go over inpatients system by system, and discharge is our priority. Sometimes we send them home doing some stuff, but typically they have to be eating, tolerating food – this is not absolutely necessary because sometimes we do send them with PN, for example, but typically for the livers, they have to be eating, tolerating food, taking their medication by mouth, usually without lines.

Rima Fawaz, MD, Medical Director, Multivisceral Transplant Program