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frequently asked questions
What is a liver transplant?
A liver transplant is a surgical procedure in which a diseased liver is replaced with a healthy one from a donor. In paediatric cases, it is usually done when a child’s liver is no longer functioning properly and cannot be repaired through other treatments.
While some liver conditions are treatable with medications or corrective surgery, others progress to chronic liver failure. A child may need a liver transplant due to several conditions, including biliary atresia, metabolic disorders, liver tumours, viral hepatitis, or cirrhosis. These conditions can cause liver failure, where the liver loses its ability to function normally.

There are two main types:

Deceased donor transplant: The liver comes from a person who has passed away but had healthy organs.

Living donor transplant: A living person, often a family member, donates a portion of their liver, which grows to full size in both the donor and recipient after surgery.

At present, only Wits Donald Gordon is able to offer living donor liver transplantation, while both centres offer deceased donor transplantation.

South Africa has specialized hospitals, such as Wits Donald Gordon Medical Centre in Johannesburg and Red Cross War Memorial Children’s Hospital in Cape Town, with teams of highly skilled surgeons, nurses, and paediatric specialists who handle paediatric liver transplants. The process follows international standards and is supported by multidisciplinary teams to ensure the best outcomes.

The waiting time depends on several factors:

  1. The availability of suitable donors.
  2. The urgency of your child’s condition (the sickest children are prioritized).
  3. The size and blood type of the liver required.


In most cases, a living donor may shorten the waiting time.

A living donor is usually a close relative, such as a parent or sibling, who is in good health and willing to donate. The donor must undergo a thorough evaluation through multiple disciplines to ensure the procedure is safe for both the donor and the recipient.
  • Less time on the waiting list, during which time complications can develop, and your child can become sicker
  • Better long-term outcomes
  • You can help schedule the time of surgery to best suit your family

Your child’s doctor will refer them to our unit, where they will be assessed. If they are eligible, they will be placed on the regional waiting list.

Like all major surgeries, liver transplants carry risks such as infection, bleeding, and complications from anaesthesia. There is also a risk of organ rejection, where the body’s immune system attacks the new liver. However, anti-rejection medication helps to reduce this risk.
Pediatric liver transplant success rates have improved significantly over the years. In South Africa, the success rate for children one year after surgery is around 80-90%, similar to international benchmarks. With proper care, children may go on to live healthy and active lives.

Hospital stay: After the transplant, your child will spend at least 2-4 weeks in the hospital for monitoring and recovery.

Follow-up care: Regular check-ups are required to ensure the liver is functioning well and to adjust medications. Your child will be on anti-rejection medications for life.
Home care: You will need to monitor your child for signs of infection or rejection, such as fever, fatigue, or jaundice, and keep in close contact with your medical team.

Funded patients are often covered through their medical scheme under prescribed minimum benefit cover, however, private patients should consult their medical aid for coverage details. This cover extends to the costs of the living donor operation if a possible donor is found. But, transplant is a long and difficult process and not all costs are covered by the medical aid. Some finances will be needed to cover out-of-pocket expenses such as transport to and from the hospital.
There are units in the government sector at both Charlotte Maxeke Academic and Red Cross Children’s hospital that are responsible for looking after state patients who need a liver transplant. Ask your local provider to make contact and refer you to one of these units to see if your child is a candidate for transplant. 
It’s essential to talk to your child in an age-appropriate way, explaining why they need the surgery and what will happen before and after. The medical and allied health team can help you in providing information to your child.

You can:

  1. Register as an organ donor to help others in need of transplants.
  2. Participate in awareness campaigns like National Organ Donor Awareness Month (August).
  3. Share your story with local media or support groups to help normalize organ donation and inspire others to register as donors.
If you have more questions, contact your child’s healthcare team or transplant centre.
Paediatric Liver & Transplant Services South Africa

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