Understanding Living Liver Donation: A Transplant Surgery Guide

Living liver donation is a type of transplant surgery. It allows a healthy person to give part of their liver to someone in need. This kind act can save lives. It also improves the lives of those with serious liver diseases like nonalcoholic steatohepatitis (NASH).^1,2

In the United States, almost 10,000 people need a healthy liver. A living donation can shorten the time a person waits on the national list. Waiting for a liver can be a long and stressful process.^1,2

Benefits of a living liver donation

Living donation has many benefits over receiving a liver from a person who has died. These benefits include:¹

• Less time waiting for a donor match
• Fewer medical problems after transplant
• Better long-term health outcomes after transplant

How does a living liver donation work?

The liver is a special organ. It is the only organ that can regrow after part of it is removed. This makes living donation a safe and life-saving option.^1,2

When a person donates part of their liver, both the donated portion and the remaining part in the donor's body can grow back to full size. This happens within 4 months after surgery. In time, the liver will work just as well as it did before.^1,2

Here’s how it works: During the surgery, doctors take a portion of the donor’s liver. They transplant it into the patient (the recipient). Doctors carefully plan which portion to take. They make sure it is the right size for the recipient. They also ensure the donor has enough liver left to return to normal function.¹

The surgeon makes a cut in the donor's stomach to reach the liver. They take the needed portion and close the cut. Next, they remove the recipient’s diseased liver. The donated piece is placed into their body. The surgeon connects the new liver to the blood vessels and the bile duct. After confirming the liver is functioning, they close the incision.¹

Who can be a living liver donor?

Living donors are healthy adults who wish to donate to a family member, friend, or even a stranger in need. (non-directed donation)³

The first step is to check whether a person is a good fit. The criteria include:^1-4

• Good physical health: Donors must be healthy. They cannot have medical conditions that make surgery risky. Potential donors must complete health screenings, such as a pap smear (for women over 40) or a colonoscopy (for people over 50).
• Healthy liver: The donor’s liver must function well. It must have no signs of disease. Doctors use blood and picture tests to confirm the liver is healthy.
• Mental health: Potential donors meet with a counselor. This ensures they are mentally prepared for the surgery and the recovery.

Matching with a living liver donor

Donors and recipients need to be compatible. They are checked for blood type, liver size, and age. Both the donor and recipient have their own medical teams to guide them.¹

Sometimes, a loved one wants to donate but is not a match. However, they may be a match for someone else. This is when a "paired donation" happens. These programs pair donors and recipients with others in the same situation. These are also called liver swaps.^1,5

What to expect from living liver donation

Here is what you can expect during the process.

For the donor:^3,4

• Hospital stay: Expect to stay in the hospital for a few days after surgery.
• Pain: Some pain at the cut site is normal. Medicine can help manage this.
• Recovery: Donors should not lift anything heavier than 10 pounds for 6 weeks. It is also best to avoid hard exercise. Full recovery can take 3 to 6 months.
• Follow-up: Doctors will check the donor's liver and overall health regularly.

For the recipient:^1,2

• Immediate benefits: Recipients often feel much better as the new liver starts working.
• Hospital stay: Recipients usually stay in the hospital for 5 to 10 days to ensure the new liver is working well.
• Life-long care: Recipients must take anti-rejection drugs for the rest of their lives. These drugs keep the body from fighting the new liver.

Talk with your liver transplant team

Living liver donation is a major gift that can save lives. It is also a serious choice. The reward of giving someone a second chance at life is monumental.³

If you are considering becoming a living liver donor, contact a transplant center. They can help you understand the process and ensure it is the right decision for you.³