No, but you can leave it in a fee-based underground parking lot (the Cluse parking lot is the closest, 200 meters from the Children's Hospital).

You can also park in the Migros parking lot at Rue Dancet 21 or leave your car in a P+R parking lot (less expensive than the Cluse/Lombard parking lot), with the closest being the Bout-du-Monde parking lot (Route de Vessy 12).

Yes, a cot is made available to you. However, only one parent is allowed to stay overnight at the hospital.

As a general rule, donations from parents or other family members are avoided. However, depending on the severity of your child's illness and the degree of urgency, this option may be considered on an exceptional basis.

It is an infection of the bile ducts due to intestinal germs. Following an intervention using the Kasaï procedure, bacteria in the intestinal loop can cause cholangitis.

In this situation, your child will receive intravenous antibiotic treatment and will be closely monitored. This means that the child’s hospital stay will be prolonged.

Following an infection, liver cell dysfunction or a bile duct problem, your child may have jaundice from birth or later.

It is due to an accumulation of bilirubin in the blood, a substance found in bile.

Your child is at a higher risk of developing complications related to an infection, especially a viral one.

For example, if transplanted children catch a respiratory illness, such as a cold, they are more likely to develop pneumonia or otitis the next time this happens.

This risk is higher immediately after the transplant and decreases over time.
 

Yes, especially during the first three months. The risk persists for the rest of the person’s life.

Almost all young transplant patients experience at least one episode of rejection.

When the condition becomes irreversible and life-threatening, recourse to a liver transplant is necessary.

In fact, in the absence of treatments to cure your child, his liver function will increasingly deteriorate (jaundice, risk of bleeding, ascites, etc.) to the point that the risk of death will exceed the risk of living with the damaged liver.

There are multiple possible complications during and after a liver transplant. They include surgical and medical complications.

Surgical complications

Despite all precautions, the following complications are the most common and occur in 5 to 10% of children with transplants. The same figures are found at the other reference centers throughout the world.

• Any surgery can cause bleeding. A child who receives a new liver very often needs a blood transfusion.
• Other complications are directly related to liver transplant surgery:
  • Thromboses (clots) in vessels that have been sutured. Thrombosis of the portal vein or hepatic artery often requires a new operation. 
  • Leakage of bile, which is often treated by the insertion of a drain. 
  • Narrowing of the bile duct most often requires interventional radiologists to insert a bile duct drain. 

There are also other surgical complications, but these occur less frequently.

Medical complications

Medical complications can be classified into three categories:

• Infections (most often viral)
• Rejection
• Side effects of medications required after the transplant can affect other organs    

Votre enfant est surveillé de très près de manière à réagir rapidement en soignant les complications et en adaptant son traitement.

Enfin, très rarement, le décès peut malheureusement survenir suite à ces complications. C’est pourquoi une greffe de foie est proposée après une longue réflexion entre les parents et notre équipe.

Ensemble, les risques et les bénéfices de la greffe ont été soigneusement évalués.  Une greffe est proposée dans l’une des deux situations : 

• si le risque vital de l’enfant avec son propre foie est plus élevé que les risques liés à la transplantation
• si la qualité de vie ou le développement de l’enfant est fortement compromis.  
   

Apart from paracetamol, please refer to the table below.

Interactions

Yes. Even if your child has a nasogastric tube. As with tacrolimus, other immunosuppressive medication, including Nifedipine®, Amphomoronal® and Mycostatin®, should preferably be taken by mouth.

The other treatments can be administered through the tube. However, because the tube is temporary, it is best for your child to get used to taking its medication by mouth.

At first, six drugs a day are prescribed, as a preventive measure, to reduce the side effects of the immunosuppressant. They protect against high blood pressure, renal failure and the risk of viral or bacterial infection. Then, this number gradually decreases over the years (1 to 3/day).

There are no contraindications for using homeopathy. In the absence of validated studies, care should be taken with products such as spagyric tinctures.

Regarding herbal medicine, vigilance is required regarding plant origin, concentrations and the quality of the preparations.

We invite you to discuss this with a team member who can get advice from the clinical pharmacology Division.

No, they should preferably be taken by mouth.

Yes, you can stay with your child, whether in intensive Care or Pediatric Surgery.

Your child will stay in Intensive Care for a few days (4 to 5 days), and then be admitted to the Pediatric Surgery floor for about 3 weeks.

The duration of hospitalization may vary, depending on the child’s state of health.
 

No. However, if one of your child’s siblings is sick, physical contact with the child who has undergone the transplant should be avoided as much as possible.

Yes, as long as you respect the expiration date shown on the package.

It is not recommended to have birds, snakes, turtles or lizards as pets because of the risk of contamination with fungi. If you already have these animals as pets, your child who has undergone a transplant must avoid any contact with them and absolutely must not help with their care, such as cleaning cages, a vivarium or other terrarium, nor feed them.

Cats, dogs, horses, cows and other animals pose no problems. However, avoid getting any new animals as pets during the first year after transplantation. 

Generally 3 to 6 months after the transplant.

Using basic hygiene measures is the best way to avoid contamination.

You should use them on a daily basis, regardless of your location and situation (hospital, home, school, travel, etc.):

• Wash your hands regularly with soap and water, for example, after using the toilet, before cooking or eating, on returning home, after recreational activities or taking a break, on leaving the hospital or the doctor’s office, etc.
• Use a water-based alcohol solution when there is no water available.
• If you have a cold, sneezing or coughing, use a tissue and dispose of it in the trash after use, and then wash or disinfect your hands.

The storage, preparation and cooking of food must be done in a "clean environment": 

• Clean your refrigerator regularly (once or twice a month)
• Wash your utensils and dishes carefully:

- either by hand with hot water and liquid dish detergent (and then dry them with a clean towel)

- or in the dishwasher with the temperature set to 60°

• Keep your work spaces clean.
• Wash your hands before cooking.
• Prepare small amounts at meals to avoid leftovers and cook all foods thoroughly.
• Store fresh or already cooked foods in the refrigerator.
• Eat leftovers, use up the baby food in jars and opened packages within 48 hours of storing them in the refrigerator.
• Cook frozen foods directly without defrosting them first.
• Never refreeze food that has already been thawed.
• Check product expiration dates.
• When shopping, wrap up fresh foods and then put them in an insulated bag to avoid breaking the cold chain.

In case of fever or pain, it is recommended to give/use only paracetamol, Dafalgan®, Panadol®, BenUron®, etc.

CAUTION: Do not give Ibuprofen®, Algifor®, Irfen®, Brufen®, Nurofen®, etc., from the NSAID family (= non-steroidal anti-inflammatory drugs) because of the risk of renal failure.

If these medications are prescribed to you, refuse them. Please feel free to contact the Center in case of doubt.