A living-donor liver transplant is a surgical procedure in which a portion of the liver from a healthy living person is removed and placed into someone whose liver is no longer working properly. The donor's remaining liver can regenerate and return to its normal size, volume and capacity within a couple of months after the surgery. At the same time, the transplanted liver portion grows and restores normal liver function in the recipient. Most liver donors are related to the transplant candidate recipients
The procedure is performed to remove a portion of the living donor’s liver to place it in the patient with end-stage liver disease. The number of people waiting for a liver transplant greatly exceeds the number of available deceased-donor livers. Living-donor liver transplant offers an alternative to waiting for a deceased-donor liver. Having a living liver donor also allows the recipient to avoid some possible health complications while waiting for a transplant. People who have a living-donor liver transplant seem to have fewer medical problems after the procedure than those who receive a deceased-donor liver, as well as a longer survival rate of the donated organ. Living-donor liver transplants are more common among children who need a liver transplant than among adults because suitable deceased-donor organs are scarce.
-The donor will regrow the part of the liver that you donated. The liver can regenerate, or regrow lost tissue. Your liver will start to work like normal 2-4 weeks after surgery. About 2 months later, it’ll be back to the size it was before the donation.
-There are complications for both donors and recipient when it comes to surgery. This can include bleeding, blood clots, leaking or narrowed bile duct, tumors and infections
On the day of the transplant, the surgeon will remove a portion of the donor liver for transplant through an incision in the abdomen. The specific part of the liver donated depends on the size of the donor liver and the needs of the recipient. Next, your surgeon remove the diseased liver and place the donated liver portion in the recipient's body, connecting the blood vessels and bile ducts to the new liver. The transplanted liver in the recipient and the portion left behind in the donor regrow rapidly, reaching normal liver volume and function within a couple of months. People who receive a liver from a living donor often have better short-term survival rates than those who receive a deceased-donor liver. But comparing long-term results is difficult because people who get a living-donor liver usually have a shorter wait for a transplant and aren't as sick as those who receive a deceased-donor liver.
To be considered for a living-donor liver transplant, both the donor and recipient must undergo a thorough health and psychological evaluation at a transplant center. Separate transplant teams will care for the donor and recipient during the evaluation process and will discuss the potential benefits and risks of the procedure in detail. For example, while the procedure often may be lifesaving for the recipient, donating a portion of a liver carries significant risks for the donor. Matching of living-donor livers with recipients is based on age, blood type, organ size and other factors.
Typically, a donor spends approximately seven days in the hospital, and will have an additional six to eight weeks of recovery time depending on how successful the surgery went. During the early recovery period, you will experience some pain and discomfort from your incision, which is usually well controlled with pain medications. You are monitored very closely early after surgery for all the appropriate signs of recovery and liver regeneration. Once your pain is well controlled, you are eating and drinking well and you are up and walking around without too much difficulty, you are discharged from the hospital. After discharge, you are advised not to lift anything heavy for at least six weeks. You are instructed not to drive while on sedating medications, which are used at least two to three weeks after discharge. You are encouraged to walk several times a day. Depending on your occupation, you may be able to return to work six to eight weeks after surgery. Your liver will begin to regenerate immediately after surgery and will be back to normal size in six to eight weeks. Your recovery after discharge will be closely monitored with routine clinic visits and laboratory tests.
Even though live liver donation is considered a very safe operation, it involves major surgery and is associated with complications, which may include:
-Possible allergic reaction to anesthesia
-Pain and discomfort
-Bleeding that may require transfusion
-Bile leakage, bile duct problems
-Scar tissue formation
-In rare instances liver failure, which may require transplantation, and death may occur.
Who is eligible to become a living donor?
These general requirements are usually needed to be met:
-Be a willing adult between the ages of 18 and 59, inclusive
-Be in good general mental and physical health
-Have no history of drug use, liver disease, HIV, or cancer
-Have a blood type compatible with the recipient
-Have a BMI less than or equal to 35
-Have an altruistic motive to donate
What is the evaluation process like for a liver donor?
1.Blood Tests: Determines whether your blood is compatible with the recipient’s blood, as well as whether your liver, kidney, and thyroids are functioning properly. Also screens for transmittable viruses, such as hepatitis and HIV.
2. Physical Exam: If your blood types are compatible, then a physician will examine you to determine your general level of health.
3. Magnetic Resonance Imaging (MRI): Creates a detailed picture of your internal organs so that surgeons have an anatomical “road map” during surgery.
4. Diagnostic Tests: These will include a CAT scan of your abdomen and a chest x-ray.
5. Screening Tests: If required, these may include an echocardiogram (EKG), pulmonary function test, and an exercise stress test.
6. Additional Consultations: You will also meet with a psychiatrist to assess your mental health and a social worker, who will discuss the donation process with you and your family.
How long does it take for the liver donor to fully recover from the transplant procedure?
On average, most donors usually fully recover between three to six weeks. However, every donor’s recovery time is different. During this period, donors will return to the hospital for routine visits so that their recovery can be monitored. By carefully assessing their health, hospital staff will help each donor determine when they can resume normal activities and return to work. This decision is informed by data from lab tests, observations of any signs or symptoms, and the judgments of both patient and staff.