Living-Donor Liver Surgery: What You Should Know

Medically Reviewed by Hansa D. Bhargava, MD on December 03, 2019

If you need a new liver, there are many reasons to consider a transplant from a living donor. For one thing, you don't have to wait as long for a new liver as you do when it's from a donor who has died. That often means you can have your transplant surgery before complications of your liver disease set in.

"Any patient with end-stage liver disease who requires a liver transplant should start thinking about a living liver donor," says Swaytha Ganesh, MD, medical director of the University of Pittsburgh Medical Center's living donor liver transplant program.

With 15,000 people now waiting for a deceased-donor liver and only 3,000 transplants a year, Ganesh says, it can be a lifesaving procedure for many.

Who Will Donate Part of Their Liver to Me?

"Most living-donor liver donations come from someone who is related to or knows the recipient," says Kim Olthoff, MD, chief of transplant surgery at the Perelman School of Medicine at the University of Pennsylvania. It may be your parent, child, sibling, cousin, in-law, or close friend.

Sometimes it's hard to ask loved ones about it. Olthoff encourages family members and friends to help spread the word.

Occasionally, someone who doesn't know you wants to be a living donor. There isn't a formal list of such potential donors, so it's up to you and your friends and family to find one.

Alyson Fox, MD, medical director of the living donor program at New York-Presbyterian Hospital, says some people find a donor through social media. For example, your friend may create an online campaign to ask if anyone's willing to help her friend find a new liver.

Donors are typically healthy people between the ages of 18 and 55.

Your donor must:

  • Have a blood type that's a good match for you
  • Be willing to donate voluntarily
  • Be in good health

Transplant centers generally won't allow someone to be a donor if he:

  • Smokes or drinks, and isn't willing to stop
  • Has a history of liver disease, diabetes, high blood pressure, or heart disease
  • Has HIV or cancer
  • Is obese
  • Had previous surgery in the belly area
  • Has substance abuse issues


How It Works

The process can only be started by a donor. After you've found someone, it's up to him to call a transplant center to say he's interested. The person receiving the liver can't do it because it might look as if you've forced the other person to become a donor, Fox says.

A transplant coordinator will talk to the potential donor, and if they meet some basic standards, they'll schedule an in-depth interview with the transplant center.

Next, an independent transplant team will check to see if your donor is suitable, the operation will be safe for them, and they understand the risks. The team may include surgeons, hepatologists (liver specialists), psychiatrists, and other professionals.

The evaluation process is very detailed. Your donor may have a physical exam, blood and imaging tests, and possibly a liver biopsy. They'll also go through in-depth interviews and consultations with the team.

After the team reviews and discusses the results, its members will decide whether or not to recommend the donor for your transplant.

While You're Waiting

You'll probably know whether your donor is approved within a month. "Usually the whole process of screening, evaluation, and decision-making takes anywhere between 2 and 3 weeks," Ganesh says.

Keep in mind that anything can happen during this time. Your health condition may change. A deceased-donor liver may become available. Your donor may be disqualified due to medical or mental health conditions. Or they may change their mind.

"It's always good to have more than one living-donor candidate on standby, if possible," Olthoff says.

During the evaluation, you'll keep your place on the deceased-donor waitlist. You won't be taken off until the day you receive a transplant.

If your donor is approved and you're ready for a transplant, you can look forward to scheduling surgery and a successful recovery with a healthy new liver.

WebMD Feature



Alyson Fox, MD, New York-Presbyterian Hospital.

Swaytha Ganesh, MD, University of Pittsburgh Medical Center.

Kim Olthoff, MD, Perelman School of Medicine at the University of Pennsylvania.

American Transplant Foundation: "Living Liver Donation."

Cleveland Clinic: "Living Donor Liver Transplantation," "What You Need to Know About Adult Living Donor Liver Transplantation."

University of California, San Francisco: "Living Liver Donor Transplant."

University of Maryland Medical Center: "Living Donor Liver Transplant."

University of Michigan Health: "Living Donor Liver."

University of Pittsburgh Medical Center: "Living-Donor Transplant: A Choice to Stop Waiting and Keep Living."

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