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Living Liver Donor Evaluation
As stated before, you do not have to be a family member to donate part of your liver to your loved one. Spouses, friends or other loved ones are eligible to be evaluated. The evaluation process for becoming a liver donor is one that is full of medical tests and meeting the transplant team. This is to insure that you are medically able to undergo this elective procedure.
What are the first steps?
- Identify the person you are interested in donating to is on the liver transplant list.
- You must have a compatible blood type. You may have your blood type checked at your primary care physician's office or your local blood service. The blood service center may charge a nominal fee.
- You must be between the ages of 18 and 55.
- It is important to be approximately the same height and weight as the recipient, so that your liver will match up in size to the recipient.
- You should have a primary care physician perform a medical evaluation to determine if your health is good enough to undergo a liver donor surgery.
After these steps are completed and you are cleared to move forward with the donation procedure, you will then undergo additional testing. These next tests to become a donor take approximately four days to complete.
- Laboratory testing is done to evaluate your liver function, blood clotting ability, kidney function, blood counts, unknown diseases, and confirm your blood type.
- You will meet the transplant psychologist (LINK) and transplant social worker (LINK TO SHEILA) to further discuss your decision and address any concerns you may have with becoming a donor
- A volumetric MRI is a radiological test done to look at the volume (size) of your various sections of your liver. This is to determine if you have enough liver to donate and leave you enough to support you after donation. This test also evaluates your blood vessels and ducts which flow throughout your liver. The third part of this test that is extremely important is to evaluate for any fat that could result in a portion of your liver not functioning properly for either you or your recipient.
- A Doppler ultrasound is a radiological test that assesses your liver. This test evaluates your liver for fat and looks at the blood vessels to ensure there is proper blood flow.
- An Echocardiogram and Electrocardiogram is done to ensure there are no problems with your heart. If either is in question, an additional test, called a Stress test may be done to further evaluate your heart status.
- A chest x-ray and arterial blood gas is done to evaluate your lung status. If you are a smoker, we will ask you to stop smoking prior to surgery to get your lungs in the healthiest shape for your surgery.
- You will meet with one of our Transplant Hepatologists(LINK), which is a liver medical doctor. He will evaluate you for possible liver donation. The doctor will ask you various medical questions to determine you eligibility of becoming a liver donor.
- A liver biopsy is a procedure that a very small piece of your liver is removed to be looked at under a microscope. This is to determine if you have anything wrong with your liver. The doctor will look at your liver cells to make sure that your liver is healthy. The right side of your abdomen is numbed and a needle is inserted into your liver, and quickly removed with a small piece of liver tissue. You must remain on your right side for four hours to prevent and alleviate any bleeding. This test may be cancelled if you do not have any risk factors.
- The final procedure is the mesenteric angiogram. This test is done to take an in depth look at the blood vessels and branches in your liver. This test, along with the MRI, determines the area that the surgeons will operate on in your liver. In combination, they are the "road maps" of your liver.
Note: If any of the evaluation tests are abnormal, there may be additional testing required or you may be determined not to be an eligible donor.
The liver transplant coordinator will be in close contact with you throughout your testing procedures. You will be notified if there are any problems that may preclude you as a donor. The test results will be reviewed each day with the living donor transplant surgeon, Robert Fisher, MD.
What happens if I am turned down as a donor?
Unfortunately, not everyone is able to be a liver donor. If your blood type is not compatible to the recipient's blood type, you cannot donate part of your liver to them. Some potential donors have previously undetected medical conditions which are found during the evaluation process. In this case, you may be referred back to your primary care physician or a specialist, depending on the problem found. If you are found to have significant fat in your liver, you may be scheduled to see a transplant hepatologist to further evaluate you for any potential liver disease. Sometimes the findings of your evaluation tests may not be harmful to you, but could potentially result in a poor outcome for you or your recipient. The transplant team will determine if this is the final outcome and notify you of the results of your tests.
The Hume-Lee Transplant Center takes all precautions with our potential donors. We want your surgery and your outcome to be the best possible; therefore, we insure that you are very healthy and medically able to undergo this operation. If you are not a candidate for donation, your support of your loved one remains very important to them. Regardless of the donation status, your generosity is appreciated by both the recipient and the transplant team.
What happens if I am an acceptable liver donor?
After you have completed your evaluation and found to be an acceptable candidate for partial liver donation, you will meet with Dr. Robert Fisher, the living donor transplant surgeon. Dr. Fisher will discuss the risks and benefits of the surgery. This will be an opportunity for you to ask any last many questions, in addition to meeting your surgeon. You will be asked to sign consent for the surgical procedure, which describes the potential risks involved for this type of surgery. This consent will be signed again upon coming into the hospital for the surgery. You will be given a list of past donors with their telephone numbers to discuss their experiences of their donation. The date of surgery will be determined by the donor, recipient, and the transplant surgeon's schedule. Due to the complexity of this surgery, the Hume-Lee Transplant Center requires three or four transplant surgeons to be present for all liver donor transplant surgeries.
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