If you decide to give part of your liver to someone who needs a new one, talk to your doctor about the different ways this can be done. There are several types of living-donor transplants, but in each case, you'll be giving someone with a damaged liver a chance to grow a new one -- and yours will grow back, too.
Directed Liver Transplants
Most living donors give part of their liver to someone they know. It could be either a relative or a friend.
If you're giving to a family member, you could be related to the person because you're their:
- Child (over age 18)
- Sister or brother
- Half-sister or half-brother
- Aunt or uncle
- Niece or nephew
If you're a "nonrelated donor," you might be giving part of your liver to your:
- Spouse or partner
- Mother- or father-in-law
Nondirected Liver Transplants
A small number of living donors give part of their liver to someone they've never met. You might decide to do this simply because you want to help another person.
Part of your liver will go to someone who is on the national organ donation waiting list. You don't need to meet the person who's getting the new liver, either before surgery or afterward. You don't even need to learn their name. It's up to you. Sometimes, donors and recipients decide to meet, but others prefer not to.
This might be an option for you if you want to donate part of your liver to someone you know, but you aren't a good match for that person.
For example, let's say you want to be a donor for your brother, but your blood types don't match. If that's the case, your doctor will help you find two other people in a similar situation -- one donor and one person who needs a new liver. The donor will have your brother's blood type, and the person who needs the new liver will have your blood type.
You basically swap. You give part of your liver to the person whose blood type matches yours, and the other donor gives part of their liver to your brother. It's an arrangement that works for all four of you.
You can think of a domino transplant as a version of the expression "pay it forward" -- repaying a good deed by helping another person. Here's how it works.
Let's say you have a metabolic disease like amyloidosis. In that condition, a protein called amyloid builds up in and damages organs like your heart and kidneys. Because your liver makes amyloid, you might need a liver transplant to treat it.
During a domino transplant, if you're a young person with a disease like amyloidosis, you get a healthy liver from a donor who has died. Then, your liver goes to an older person with liver cancer who needs a new liver. The liver you gave them may eventually cause them to get amyloidosis, but it won't happen for a long time. The disease can take 20 years to develop. In the meantime, they'll have a healthy life.
How to Find the Right Liver Match
Doctors do tests to match someone who needs a liver with the right donor. Whether you're a donor or recipient, you'll have to answer a lot of questions about your medical history. You'll also get tests to check your blood and tissue types to make sure you are a good match.
How to Prepare for Surgery
There are key steps to take to prepare for surgery. Your recovery will be smoother if you get tests to check your health, avoid some drugs and supplements, and follow the right diet.
Evaluation. Before surgery, your doctor may ask you to get tests to make sure you're healthy enough for a transplant operation:
- Blood test
- Urine test
- Pap smear for women
- Mammogram for women over 40
- Colonoscopy if you're over 50
- Echocardiogram to check your heart health
- X-rays or other scans
You may also visit with a social worker or counselor to ease your concerns about your surgery and recovery.
Follow these tips to help make surgery a success and speed up your recovery:
- Take all your medications as prescribed.
- Keep your doctor's appointments. Use these visits to ask questions about your surgery or recovery.
- Relax with friends and family so you're at ease when you go into surgery.
- Sign your informed consent forms. Ask questions if there's anything on them you don't understand.
Drugs. For a week before liver surgery, don't take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or aspirin. They make it hard for your blood to clot. You may be able to take acetaminophen for mild pain, but don't use it unless your doctor says it's safe for you.
If you're a woman and you plan to be a liver donor, don't take birth control pills for a month before surgery. These drugs can also cause problems in how your blood clots. Ask your doctor about other types of birth control you can use.
Herbs, vitamins, and supplements. Don't take any as your surgery nears unless your doctor says it's OK. A supplement called kava kava could even cause liver failure.
Diet and exercise. Eat healthy foods and stay as active as possible in the weeks before your surgery. This will help you fight infections and recover more easily afterward. Go for a walk or swim. Don't lift heavy weights, though, because that could strain veins in your liver.
Eat right. If you need a new liver, it's possible you're underweight because of your health problems. Protein-rich foods like eggs, meat, fish, and soy can build up your muscles. Eat a low-sodium diet to lower your chance of having fluid buildup (edema) after surgery. This also helps control high blood pressure.
If you're a donor and you're overweight, try to lose a few pounds once your surgery date is set. Extra weight can strain your liver after the operation. Even a little weight loss can ease your recovery.
Skip alcohol. If you need a new liver, don't drink or take recreational drugs. Even a little alcohol can make liver diseases worse. If you're getting a liver transplant because of alcohol abuse, you may need to pledge to never drink again after the operation.
If you're donating part of your liver, you also shouldn't drink alcohol from the time your surgery is set. Tell your doctor if you abused alcohol in the past. You may need a biopsy to make sure your liver is healthy enough to donate. After your surgery, your doctor will tell you when it's safe for you to drink again.
Stop smoking. Quitting tobacco 1-2 months before surgery can help cut the chance of complications. Quitting smoking even right before surgery can increase the amount of oxygen in your body. After 24 hours without smoking, nicotine and carbon monoxide are already gradually broken down in the blood. Your lungs start to work better after about 2 smoke-free months.
Plan for Surgery and Recovery
You'll need to stay in the hospital for up to a week after surgery. If you're getting a new liver and you were extremely ill before your transplant, you may need to stay for several weeks.
Plan for someone to help take care of you, your small children, your pets, or your home while you recover, or give you rides while you're on pain medicine.
If you're a donor, you can store up to 2 pints of your own blood in case you need a transfusion during surgery.
Before surgery: You’ll need to scrub your body with antibacterial soap once the night before and twice the morning of the surgery.
From noon the day before your liver surgery, don't eat or drink anything but clear liquids. This helps prevent nausea or vomiting during and after surgery. It also helps you empty your bowels for your operation.
As your liver surgery nears, ask your doctor or other transplant team members any questions you have about your surgery and its risks, or what to expect during recovery.
Check with your employer when you schedule your surgery. Find out if you can take paid vacation or sick leave for your recovery. You also can take unpaid time under the Family and Medical Leave Act (FMLA).