Living Liver Donation

During the transplantation, the donor and recipient each have their own surgical team and are in adjacent operating rooms.

In the donor’s operating room, surgeons remove part of the liver, usually the right half or lobe. Doctors also remove some of the blood vessels and ducts that assist with the function of the liver.

In the recipient’s operating room, surgeons remove the recipient’s entire diseased liver and prepare to immediately transplant the donated liver segment, blood vessels and ducts.

The dual surgery process takes 10 to 12 hours and requires a seven-day hospital stay for the donor. The liver takes roughly six weeks to grow to full size for the donor and recipient.

Donating a portion of your liver to a family member or loved one reduces the waiting time for the recipient and saves them from the stress of being on a waiting list. The recipient is often in the best health to undergo the transplant, which improves recovery time. Additionally, the organ from a living donor is often healthier than those donated after death.

* Data from OPTN/SRTR 2011 Data Annual Report: Liver

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 includes medical tests and meeting the transplant team to ensure that you are medically able to undergo this elective procedure.

Donors must be between the ages of 18 and 55. Once you identify the person you are interested in helping on the liver transplant list, you must confirm that you have a compatible blood type. You may have your blood type checked at your primary care physician’s office or your local blood service.

Additionally, 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.

Before moving forward, 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 you are cleared to move forward with the donation procedure, you will undergo additional testing, which takes approximately four days to complete. This includes:

• Laboratory testing to evaluate your liver function, blood clotting ability, kidney function, blood counts and unknown diseases, and to confirm your blood type
• A meeting with the transplant psychologist to further discuss your decision and address any concerns you may have with becoming a donor
• A volumetric MRI to determine if you have enough liver to donate a segment without risking your health
• A Doppler ultrasound to assess your liver for fat and ensure proper blood flow through your blood vessels
• An echocardiogram and electrocardiogram 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 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.)
• A meeting with one of our transplant hepatologists to evaluate you as a liver donor
• A liver biopsy to make sure your liver is healthy
• A mesenteric angiogram to take an in-depth look at the blood vessels and branches in your liver and help determine the area on which the surgeons will operate

The liver transplant coordinator will be in close contact with you throughout your testing procedures. Additional testing may be required if any of the evaluation tests are abnormal.

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.

Some potential donors have previously undetected medical conditions that 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 impact your health, but could potentially result in a poor outcome for you or your recipient. You will be asked to get bloodwork done initially to check blood type and other clinical items that could determine capability. The transplant team will determine the final outcome and notify you of the results of your tests.

After you are accepted as a candidate for partial liver donation, you will meet with the living donor transplant surgeon to discuss the risks and benefits of the surgery. This provides an opportunity for you to ask any last-minute questions.

You will be asked to sign a consent form, which describes the potential risks involved in this type of surgery. This consent will be signed again upon coming into the hospital for the surgery.

To provide you with firsthand information on what it’s like to be a donor, we will give you a list of past donors and their contact information so you can get in touch with them directly.

Due to the complexity of this surgery, the Hume-Lee Transplant Center requires three or four transplant surgeons to be present for all living donor liver transplant surgeries. The date of surgery will be determined by the donor, recipient and the transplant surgeons’ schedules.