Living Liver Transplantation
Liver transplantation, or liver transplant surgery, is a highly specialized and effective treatment for end-stage liver disease. The number of liver donors is much less than the number of patients waiting for a liver transplant. Currently in the United States, there are more than 17,000 patients waiting for a liver transplant. Because of the lack of donor organs, there are only approximately 6,500 liver transplants performed each year. In fact, nearly 1,800 people die each year waiting for a liver transplant.
Living donor liver transplantation (LDLT) is one way to address the shortage of donor organs. LDLT allows your health care team to schedule an elective liver transplant operation at a mutually agreed upon time - enabling the donor, the recipient, and their immediate circle of family to plan ahead for absences from work, childcare, and other concerns.
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What is living Donation?
Living donation takes place when a living person donates an organ or part of an organ for transplantation to another person. Living donation is an alternative for individuals who are waiting on the transplant list for a deceased donor organ.
What are the advantages of living liver donation over non-living donation?
Transplants performed from living donors may have several advantages compared to transplants performed from deceased donors:
- There is no need to wait for a cadaveric liver to become available (most living transplants take place four to six months after the evaluation process begins).
- Living related transplants can be scheduled. This allows both you and the donor to plan for absences from work, childcare, and other social concerns.
What are the qualifications for living donors?
In order to qualify as a living liver donor, an individual must be physically fit, in good general health, and free from, diabetes, cancer, lung disease, heart disease, HIV infection, known viral hepatitis, active alcoholism, or psychiatric illness. Be of sufficient height and weight. Gender and race are not factors used in determining a successful match. As a living donor you must first undergo a blood test to determine if your blood type is compatible with the recipient. This does not always mean they are the same blood type. If you and the recipient have compatible blood types, you will then undergo an extensive physical work-up to make sure it is safe for you to donate.
The decision to become a living donor is a voluntary one, and you may change your mind at any time during the process. Your decision and reasons are kept confidential.
What are the costs related to living donation?
The pre-operative evaluation, surgery, hospital stay, and outpatient visits, as well as any medical treatment related to the donor surgery within the first three months will not cost you anything. The recipient’s insurance company will pay for all costs that are not covered by your insurance.
Your only direct costs related to liver donation may be medications such as pain pills that you may need after returning home from the Medical Center. You will also need to pay for transportation and non-hospital lodging costs related to the evaluation and surgery. Keep in mind that you should plan your household expenses and finances ahead of time to account for time off from work during the evaluation, surgery, and full recovery. Be sure to check with your company’s Human Resources Department to learn what your options are under the Family Medical Leave Act, and for short-term disability and time off. This will be an important part of your decision-making process.
Is there risk with living liver donation?
There are risks involved in any major surgery. In an LDLT, the risk of problems is about 30 percent (2 in 7 cases), and the risk of death is estimated at 0.15 percent (1 in 670 cases).
Most problems are minor, and get better on their own. The most common problems after donating part of your liver are bleeding, infection, and pain related to the surgery.
Sometimes, the problems are serious enough to require another surgery or medical procedure. The most common liver-related problem is a bile leak. Bile is a secretion of the liver that helps digestion. This can happen in 5 to 15 percent of cases. Most bile leaks get better without the need for surgery. Sometimes, tubes need to be placed through the skin to drain and aid in the healing process of bile leaks. In rare cases, surgery is needed to correct the bile leak. Biliary strictures (narrowing or constrictions of the ducts conveying the bile from the liver) can also occur. Some of the strictures can be fixed by non-surgical means such as the insertion of tubes, but some will require surgical repair.
Will donating a part of a liver prevent you from becoming pregnant or fathering a child?
If I am cleared to be a donor, how is it decided when the transplant will take place?
This decision is made jointly by the transplant team, by you, and by the recipient. The transplant team, particularly the physicians involved directly in your recipient's care, will determine as accurately as possible the best time to do the transplant, based on the recipient's medical condition.
Once the transplant is scheduled, will it definitely happen?
A number of events could happen that may change the date of the transplant. For example, the recipient's condition might deteriorate to the point where he or she is too sick for a transplant. Or, the recipient or donor might develop an infection or some other condition that would need to be treated before the transplant could be done.
For further information please visit the Scientific Registry of Transplant Recipients (SRTR) website.
Data source: UNOS/Scientific Registry of Transplant