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Living-Donor Liver Surgery: What You Should Know

author2023.04.12

In this Article

  • Benefits of Living-Donor Liver Donation
  • Who Can Be a Living Donor?
  • The Evaluation Process
  • Who Pays for the Transplant?
  • During the Transplant
  • How to Find a Donor
  • How to Donate

With most liver transplants, the person who needs a new liver gets it from someone who’s deceased. Living-donor liver donations come from someone who’s still alive, like a family member or friend.

The donor gives you a piece of their healthy liver, which replaces your damaged one. The donor’s liver and the recipient’s liver both grow to a normal size within a few months.

Benefits of Living-Donor Liver Donation

Shorter wait. More than 14,000 people are on the national wait list for a liver transplant, and there aren’t enough organs for everyone. If you choose a living-donor liver donation, it may cut down your wait time. This can be lifesaving if your liver is getting worse or you have other health conditions. It also helps the next person on the list.

Faster, easier recovery. You may have a shorter stay in the hospital. You’re also less likely to need a blood transfusion or dialysis after surgery.

Better outcome. Your long-term outcome might be better. Livers from living donors may last longer than livers from deceased donors.

Convenience. It’s organized in advance, so everyone has time to plan for the surgery and recovery period. This includes you and the donor, as well as your family members and caregivers.

 

Who Can Be a Living Donor?

A living donor can be anyone who medically matches with you. It may be someone you know, like a close relative, friend, or co-worker. This is called a directed donation. Or it may be someone you don’t know who wants to be an organ donor. This is called a nondirected transplant and it’s organized by your transplant team.

A donor must:

  • Be 18 years or older
  • Be physically and emotionally healthy
  • Have no health issues, like liver or kidney disease, uncontrolled high blood pressure, infections like HIV, or cancer
  • Be drug-free
  • Understand the risks

A donor may not be approved if they have:

  • Active infections
  • A history of alcohol or substance abuse
  • Severe liver disease

The Evaluation Process

Your transplant team will do a medical and psychological evaluation before giving your living-donor liver transplant a green light. They want to be sure you’re both physically and emotionally ready.

It may include:

  • A physical exam
  • Blood tests
  • An MRI (this takes detailed pictures of the inside of your body)
  • Diagnostic tests like X-rays and CAT scans
  • Screenings like EKGs and stress tests
  • Meetings with other health care workers, like a mental health professional

Who Pays for the Transplant?

Your insurance company may pay for pretransplant evaluation, transplant surgery, and follow-up appointments. If you’re a donor, the recipient’s insurance may pay these costs. The recipient usually pays the donor’s nonmedical expenses, like travel, meals, child care, and lost wages. Your hospital’s financial coordinator can help you figure out what options are available.

The National Living Donor Assistance Center (NLDAC) may also be an option. It pays for the donor’s evaluation, surgery, and follow-up appointments. A donor’s eligibility for the program is based on the recipient’s household income.

During the Transplant

A team of doctors will perform surgery on both of you at the same time. The surgeries will be in separate operating rooms.

It may take about 4-6 hours to cut out a piece of the donor liver, then 6-12 hours to put it in the recipient.

You’ll likely stay in the hospital for 1 week after surgery. If you’re a donor, recovery may take about 3-6 weeks. If you’re a recipient, it may take about 3-6 months. Everyone is different — it depends on things like your age and overall health.

How to Find a Donor

If you’d like to find a living donor, try these tips when looking for a match:

Share your story to reach more people. Tell friends, family, acquaintances, and other people you meet that you need a donor. Announce it on social media platforms. Share photos. Put a window decal on your car. Make it easy for people to find out and contact you.

Ask a friend or family member to be your advocate. This can help get your story out to possible donors.

Reach out to the American Transplant Foundation. They have a potential living donor database and mentors who may be able to help you find a donor.

How to Donate

Talk to your family, close friends, and doctor if you’re thinking about becoming a living donor. Learn what it involves and what the risks are. Get as much information as you can and take time to make a decision.

Show Sources

SOURCES:

American Liver Foundation: “An Introduction for Donors and Recipients.”

American Transplant Foundation: “Become a Living Donor,” “Finding a Living Donor,” “Living Liver Donation Overview.”

Columbia Surgery: “Living Donor Liver Transplantation.”

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