Transplant procedures

Abdominal ultrasound (sonogram)

This is an ultrasound of the abdomen. This test uses sound waves to draw a picture of the abdominal organs that can be seen on a TV screen and recorded on videotape. The sonogram gives doctors another way of looking at how well the abdominal organs are working, and measures their size. Your child will lie on a bed and lubricating jelly will be placed on his/her stomach. The technician will slide a transducer (which is like a microphone) over the stomach to obtain the pictures. This test uses no needles and does not hurt, but it does take about 20 to 40 minutes. During the test your child will need to lay still. For this reason, most babies and toddlers are given medicine to help them sleep for this test. Older children will be able to watch a video during the test; we have several from which to choose.

Arteriogram

Contrast is injected into blood vessels to determine if there is any blockage to the arteries or veins leading to or from an organ.

Cardiac catheterization

A cardiac catheterization checks the pressure inside the heart and lungs. Small tubes called catheters are put into blood vessels in the groin or neck. The small tubes are passed through the blood vessels into the chambers of the heart and out to the lungs to measure pressure and oxygen levels. This test takes about two to four hours. Your child will be sedated for this test.

Cholangiogram

This is an ultrasound of the bile ducts. The cholangiogram gives doctors another way of looking at how well the bile ducts are draining. Your child will lie on a bed and lubricating jelly will be placed on his/her stomach. The technician will slide a transducer (which is like a microphone) over the stomach to obtain the pictures. This test uses no needles and does not hurt, but it does take about 20 to 40 minutes. During the test your child will need to lay still. For this reason, most babies and toddlers are given medicine to help them sleep for this test. Older children will be able to watch a video during the test; we have several from which to choose.

CT scan

A computerized tomography (CT) picture which shows the size, shape, and major blood vessels in the body. Medicine may be injected into your child's bloodstream to better see his or her organs during the CT scan. In order to get an accurate picture, your child must lie very still during a CT Scan. Therefore, sedation may be administered if your child is very active or anxious.

Echocardiogram (echo)

This is an ultrasound of the heart. This test uses sound waves to draw a picture of the heart that can be seen on a TV screen and recorded on videotape. The echocardiogram gives doctors another way of looking at how well the heart muscle and valves are working, and measures the size of the heart. Your child will lie on a bed and lubricating jelly will be placed on his/her chest. The technician will slide a transducer (which is like a microphone) over the chest to obtain the pictures. This test uses no needles and does not hurt, but it does take about 20 to 40 minutes. During the test your child will need to lay still. For this reason, most babies and toddlers are given medicine to help them sleep for this test. Older children will be able to watch a video during the test; we have several from which to choose.

Electrocardiogram (EKG)

An electrocardiogram (EKG) test measures the electrical conduction pattern through the heart. Several “stickers” (also known as leads) will be placed on your child’s chest and connected to a machine that receives the electrical impulses from your child’s heart and records them on paper. When the test is over, the stickers will be removed. This test only takes a few minutes. It is not painful, and no medicine is needed to help the patient sleep.

Endoscopy

An endoscopy is a procedure in which a flexible fiberoptic tube is placed down the esophagus, through the stomach and into the small intestine (duodenum) to determine the cause of bleeding or to evaluate ulcers. Enlarged veins (varices) are often the result of long-standing liver disease and may be treated with endoscopic techniques.

Gastrointestinal diagnostic x-rays

These include an upper GI series (barium swallow), X-rays of the small bowel or barium enema to evaluate the gastrointestinal tract.

Heart biopsy

Your child will be taken to the cardiac catheterization lab and given medicine to help sleep. A catheter, or tube, will be inserted through a large vein in the neck or groin into the right chamber of the heart. Through this tube, a wire with a pincher on the end will be inserted into the heart where it will take six to eight pieces of heart muscle; each one is no bigger than a pin point. The removal of these pieces will not hurt the heart. During the procedure the heart may have some abnormal heart beats but this will go away after the procedure. After the heart pieces are collected, the tube is removed, pressure is held over the area for 20 minutes to control any possible bleeding and a band-aid is placed to the insertion spot. The 6 to 8 pieces are sent to a Pathologist who looks at them under a microscope and reports the findings to the Transplant Team.

Kidney biopsy

Your child will be given medicine to help sleep. A catheter, or tube, will be inserted through a special needle into your child’s kidney. Through this tube, a wire with a pincher on the end will be inserted into the liver where it will take pieces of the kidney; each one is no bigger than a pin point. The removal of these pieces will not hurt the kidney. After the kidney pieces are collected, the tube is removed, pressure is held over the area for 20 minutes to control any possible bleeding and a band-aid is placed to the insertion spot. The 6 to 8 pieces are sent to a Pathologist who looks at them under a microscope and reports the findings to the Transplant Team.

Liver biopsy

Your child will be given medicine to help sleep. A catheter, or tube, will be inserted through a special needle into your child’s liver. Through this tube, a wire with a pincher on the end will be inserted into the liver where it will take pieces of the liver; each one is no bigger than a pin point. The removal of these pieces will not hurt the liver. After the liver pieces are collected, the tube is removed, pressure is held over the area for 20 minutes to control any possible bleeding and a band-aid is placed to the insertion spot. The 6 to 8 pieces are sent to a Pathologist who looks at them under a microscope and reports the findings to the Transplant Team.

Magnetic resonance imaging (MRI)

This test takes special pictures of the body’s organs to see if any defects are present. The MRI camera looks like a short tunnel. Your child will lie on an exam table that will move slowly through the “tunnel” while the pictures are taken. Your child should be aware that the camera is noisy, but it will not touch his/her body and it will not hurt. He/she will need to be still for this test to get the best picture, so babies and very young children are usually given medicine to help them sleep. This test can take 25 minutes to one hour. Children with pacemakers or other metal implants will not be able to have an MRI, but will have a head CT (computed tomography) scan instead. The CT scanner is like the MRI camera, except that it looks like a large donut rather than a tunnel. An MRI can take between 10-45 minutes.

Pulmonary function tests (PFTs)

The pulmonary function tests (PFTs) show how well a child’s lungs can expand and how well oxygen is carried to the blood. If your child is tall enough (about 40 inches) and old enough to cooperate, he or she will be asked to breathe into a tube connected to a machine. The test takes about 20 minutes.

Radiology studies

A chest x-ray (CXR) allows us to look at the size of the organs in the thoracic cavity. Spinal x-rays and hand x-rays will be done to measure bone age, and help to assess bone structure before transplant. A child’s “bone age” may be different from his/her actual age in years and these x-rays help us to measure your child’s potential for future growth. Each x-ray takes only a few minutes and it is not painful.

Voiding cystourethrogram (VCUG)

VCUG is a special x-ray done to evaluate the urinary drainage system including the bladder and ureters (the tubes that carry the urine from the kidney to the bladder). During this test, a small catheter will be inserted into the bladder. The test will evaluate the bladder (size, shape and capacity) and show if urine backs up into the kidney during voiding.