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Liver Transplant: Living Liver Donation

Our Liver Transplant Program at University of Colorado Hospital is one of the first in the United States to offer transplant surgery between two living adults, which is commonly called living organ donation.

Our own experience includes more than 100 adult-to-adult living donor liver transplants since 1996.

What is it?

In living liver donor surgery, the donor and the recipient are placed in side-by-side operating rooms. A surgeon removes a part of the donor's liver, typically the right half. This donated segment of the liver is then immediately placed in the recipient in the next operating room.

The remaining part of the donor's liver is sufficient to maintain normal body functions. The recipient receives a large enough segment of the donor liver to maintain body functions as well.

During approximately the next two months, the remaining and transplanted parts of the donor liver grow to normal size, providing normal long-term liver function for the donor and the recipient.

 

Transplant eligibility

Is anyone eligible for living donor liver transplantation?

Patients must be considered individually to make sure that living donor transplantation is appropriate based on their specific medical situation. Some patients may have specific medical problems that would prevent them from having a successful living donor transplant.

Who can be a living liver donor?

Living donors must be over the age of 18 and under the age of 55. Potential donors must be in excellent medical and psychological health. Most donors are family members (spouse, parent, sibling, son, daughter, nephew, niece) of the recipient or a very close personal friend.

I've decided to be a donor. Now what?

If you've decided to be a living liver donor, then a series of psychological and medical testing follows to determine if you are in fact an eligible candidate.

The first phase of testing includes:

  • Medical history and physical examination
  • Blood tests (the blood type must be compatible with the donor, but it does not have to be an exact match)
  • Chest X-ray and EKG

These tests usually require two to three doctor visits. It is preferable that this testing is done at the University of Colorado Hospital in Denver by members of our liver transplant team. However, potential donors from outside of Colorado may undergo this initial phase of testing in their local community, provided their physician is in consult with our transplant team.

If these initial tests suggest that you would be a suitable donor, then another series of tests will be done.

The second phase of testing includes:

  • Evaluation and discussion of the liver surgery with a transplant surgeon
  • Psychological evaluation
  • MRI scan of the liver (which is similar to a CAT scan)

If all of these tests show that you are a suitable donor, the donor surgery and the liver transplant may be performed at the earliest appropriate time for you and the recipient. This can be as short as a few hours or as long as several weeks after you complete the evaluation.

Frequently asked questions

How long will the living liver donor be in the hospital and out of work?

Usually, the donor is admitted to the hospital the same day the surgery is performed.

The hospital stay after donor surgery is on average five to eight days.

If the donor lives outside of the Denver metropolitan area, he/she may be asked to stay in the Denver area for up to two weeks after the donor surgery.

Most people are able to return to work after eight weeks, depending on how the surgery goes and the type of job they have.

If the donor has a desk job, he/she may be able to return to work sooner than patients with a more physically demanding job.

How will liver donation affect my life after surgery?

The liver is the only major organ in the body that is able to regenerate itself. Thousands of patients have undergone partial removal of their liver for medical problems. In these patients, the liver is able to regenerate itself back to its normal size and function after about two months.

The experience with living liver donors is much more limited, but has been identical: patients have had complete regeneration of their liver with return to normal size and function after two months. Therefore, we do not believe that donating a part of your liver will affect your liver function in the long-term.

What are the risks of becoming a living liver donor?

Any time major surgery is done there are risks involved. The most common problems encountered with donor surgery include:

  • Bleeding
  • Infection
  • Pain related to the surgery

The risk of dying from donating a portion of the liver is estimated to be one in 500.

Am I making the right decision to become a living liver donor?

This is a question only you can answer. Living donation is not for everyone. You may find it helpful to talk with another patient who has been a living liver donor to discuss your feelings and concerns about becoming a donor. If you are interested in meeting another living liver donor, ask a member of the transplant team to help arrange this.

What happens if I decide not to become a living liver donor?

If you decide not to become a donor, the recipient will remain active on the conventional transplant list. The recipient also may elect to find another potential living donor.

How much will it cost me to become a living liver donor?

The treatment related to the donor surgery within the first three months will not cost you anything. This includes your:

  • Pre-operative evaluation
  • Surgery
  • Hospital stay
  • Outpatient visits
  • Medical treatment

These costs are paid by the recipient or the recipient's insurance company.

Your only direct costs related to the donation may be:

  • Time off work
  • Medications such as pain pills and antibiotics after your hospital stay
  • Transportation
  • Non-hospital lodging costs related to the evaluation and surgery

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