Where Does a Liver for a Transplant Come From?
There are two types of liver transplant options: living donor transplant and deceased donor transplant.
Living donor liver transplants are an option for some patients with end-stage liver disease. This involves removing a segment of liver from a healthy living donor and implanting it into a recipient. Both the donor and recipient liver segments will grow to normal size in a few weeks.
The donor, who may be a blood relative, spouse, friend or even unrelated "Good Samaritan," will have extensive medical and psychological evaluations to ensure the lowest possible risk. Blood type and body size are critical factors in determining who is an appropriate donor. ABO blood type compatibility is preferable as well as donors less than 60 years of age.
Recipients for the living donor transplant must be active on the transplant waiting list. Their health must also be stable enough to undergo transplantation with excellent chances of success.
In deceased donor liver transplants, the donor may be a victim of an accident or head injury. The donor's heart is still beating, but the brain has stopped functioning. Such a person is considered legally dead, because his or her brain has permanently and irreversibly stopped working. At this point, the donor is usually in an intensive-care unit and life support is withdrawn in the operating room during the transplant.
The identity of a deceased donor and circumstances surrounding the person's death are kept confidential.
Screening for Liver Transplant Donors
Hospitals will evaluate all potential liver transplant donors for evidence of liver disease, alcohol or drug abuse, cancer, or infection. Donors will also be tested for hepatitis, HIV, and other infections. If this screening does not reveal problems with the liver, donors and recipients are matched according to blood type and body size. Age, race, and sex are not considered.
The transplant team will discuss transplantation options with you at a pre-transplant evaluation, or you can contact the transplant team for more information.
What Happens When They Find a Liver Transplant Match?
When a liver has been identified, a transplant coordinator will contact you. Make sure that you do not eat or drink anything once you have been called to the hospital. The transplant coordinator will notify you of any additional instructions. When you arrive at the hospital, additional blood tests, an electrocardiogram, and a chest X-ray will generally be taken before the operation. You also may meet with the anesthesiologist and a surgeon. If the donor liver is found to be acceptable, you will proceed with the transplant. If not, you will be sent home to continue waiting.