Living-Donor Liver Transplant Procedure
Overview
A living-donor liver transplant is a surgical procedure where a healthy individual donates a portion of their liver to someone with serious liver disease. Surgeons use a part of the donor’s liver, usually from the right or left lobe, depending on the needs of the recipient. After donation, both the donor’s remaining liver and the transplanted portion grow back to normal size within a few months.
Living donors help people with liver failure, cirrhosis, and some liver cancers. Medical teams match blood types and check organ sizes to ensure a good fit between donor and recipient. Living donor liver transplants often offer a faster recovery for recipients compared to deceased-donor liver transplants.
Reasons for Choosing This Procedure
There are several reasons to consider a living-donor liver transplant:
- Shorter Waiting Time: The waiting list for a liver transplant is long, and the number of deceased donors is limited.
- Better Outcomes: Recipients of living donor transplants may experience fewer health complications and better short-term survival rates.
- Reduced Disease Risks: Avoiding a long wait on the transplant waiting list can prevent further health problems related to organ failure.
- Pediatric Advantage: Children needing liver transplants are often helped more by living donor procedures since finding deceased donor organs of the right size is difficult.
This option is typically for patients with chronic liver disease, hepatitis, or those who are at high risk of complications from liver failure.
Steps to Begin Donor Assessment
Anyone interested in becoming a living liver donor must start with a health questionnaire, typically available through a transplant center. The first step is to see if the potential donor’s blood type matches that of the person who needs the transplant. The donor evaluation process usually includes:
- Blood tests to check blood type and health status.
- Chest X-ray and MRI to evaluate liver structure and health.
- EKG (electrocardiogram) to check heart health.
- Comprehensive medical and psychological assessments.
- A meeting with a donor advocate and transplant surgeon.
Family members or friends often serve as donors, but strangers can also donate nondirected. Medical teams may evaluate those who have donated a kidney for liver donation as well.
Donor Evaluation Checklist
| Step | Purpose |
|---|---|
| Blood Tests | Check for medical compatibility |
| Imaging Studies | Assess liver volume and anatomy |
| Psychological Exam | Ensure mental readiness |
| Physical Exam | Review general health |
| Donor Questionnaire | Screen for risk factors |
What Happens Before, During, and After Surgery
Before the Surgery
Both donor and recipient complete detailed evaluations at the transplant center. Every person meets with a team including a hepatologist, transplant surgeon, and psychologist. The team discusses risks, benefits, and necessary care. The donor must have good overall health, including no hepatitis or HIV.
During the Surgery
- The donor receives anesthesia.
- Surgeons remove either the right or left lobe of the liver, usually through an abdominal incision.
- Surgeons remove the recipient’s failing liver, then place the donated liver portion in its spot.
- Surgeons carefully connect blood vessels and bile ducts.
After the Procedure
Donors typically stay in the hospital for several days. The care team focuses on pain management and closely monitors wound healing. Recipients often notice improved health as the new liver begins to function quickly.
The care team schedules regular follow-up appointments. They monitor both donor and recipient for infection, healing, and proper liver regrowth. In most cases, the liver returns to normal size and function within two to three months.
Key Points
- Recovery times differ. Most donors return to normal activities within a couple of months.
- Recipients may recover faster compared to those who receive a deceased-donor organ.
- The transplant center’s care team provides long-term support for both parties.
Recovery and Outcomes
Donor Recovery
Most living liver donors recover well, though it takes time. Hospital stays typically last 5 to 7 days, depending on the individual’s healing progress. Donors may experience pain, fatigue, or digestive changes in the first few weeks, but these symptoms gradually improve.
Most people return to normal daily activities within 6 to 8 weeks, although full recovery may take a few months. The liver’s ability to regenerate plays a key role in recovery. Within 2 to 3 months, the donor’s remaining liver usually grows back to near its original size and function.
Follow-up care includes checkups, blood tests, and imaging to confirm liver health. Long-term complications are rare but may include bile leaks, infection, or temporary changes in liver enzymes. Most donors return to their usual quality of life and can lead healthy lives after donation.
Recipient Recovery
For the recipient, health often improves quickly once the new liver starts working. Many experience better energy, appetite, and overall function within days of the transplant. Recovery usually involves a hospital stay of 1 to 2 weeks, followed by several months of careful monitoring. Anti-rejection medications (immunosuppressants) are prescribed to prevent the immune system from attacking the transplanted liver.
These medicines may continue for life and require regular adjustments based on lab results. Routine follow-ups help ensure that the liver functions well and that any complications—such as infection, rejection, or blood vessel problems—are caught early. Living-donor liver recipients may have:
- Faster recovery compared to those who receive a liver from a deceased donor.
- Shorter waiting times, which can lower the risk of severe illness before surgery.
- Better early outcomes in many cases, including improved survival rates.
Outlook and Long-Term Results
The long-term success of a living-donor liver transplant depends on many factors, including the cause of liver failure, the recipient’s overall health, and adherence to follow-up care. For both donors and recipients, long-term survival and quality of life are generally excellent.
Most donors report high satisfaction with their decision to donate and recover fully. The transplant team continues to support both individuals well beyond the initial recovery period, helping to maintain liver health, manage medications, and address any emotional or physical challenges.
