FAQ About Living-Donor Liver Transplants

What Is a Living-Donor Transplant?

Surgeons take part of a healthy liver from one person and put it into someone whose liver is damaged by disease. It's different from a traditional liver transplant, which uses all or part of a liver from someone who has died. The liver is an amazing organ because a small slice of it can grow back into full size.

What Are the Advantages?

If you get part of a liver from a living donor, you won't have to wait on a transplant list for an organ from someone who's died. That means you'll get the transplant sooner, when you're healthier. The earlier you have surgery, the greater the odds it will be a success.

Who Can Be a Living Donor?

You're a good candidate to donate part of your liver if you're a parent, sibling, or adult child of the person who needs the transplant. If you're a friend, you may be able to donate if your blood type is a good match. You usually need to be between 18 and 60 and in good health. You will be checked to see if you are healthy enough to donate.

Who's Eligible for a Transplant?

To get the surgery, your current liver has to be damaged by illness or injury. Your doctor will look at your MELD score, a number that helps your doctor tell the severity of your liver disease and prioritize people for liver transplant. You also need to have someone who's willing to donate part of their liver to you.

Who Is Eligible to Donate?

You'll get tests to make sure you're a good match and your liver is healthy. You need to be:

• In good health with no major medical or psychiatric illnesses.
• A nonsmoker for 1-2 months before the surgery.

You may also need tests like a chest X-ray, an abdominal ultrasound, and an EKG.

What Are the Risks to the Donor?

Giving away part of your liver usually is safe, but like any major surgery, there's a risk of bleeding, blood clots, infections, allergic reactions, and damage to nearby organs. There's also a chance you could get a hernia or leaking of digestive fluid, called bile, from ducts that connect your liver and gallbladder. It's rare, but sometimes the surgery can damage your liver so that it stops working. If that happens, you might need your own liver transplant.

Is It Risky to Get a New Liver?

The surgery can have risks like bleeding and infection. Your body might also reject the new organ. Your doctor will give you medicines to prevent this, but those drugs can make you more likely to get infections or cancer. If you still have the disease that caused your liver to fail, it could also damage your new liver.

How Do You Prepare for Surgery?

Whether you donate a liver or receive one, you need to stop smoking a month or two before the operation. Smoking makes your operation riskier and slows your recovery. The donor also needs to stop drinking alcohol. Tell your surgeon about any medicines you take. You might have to stop taking certain drugs, especially aspirin and other medicines that thin your blood, before your surgery.

What Happens During Donor Surgery?

You and the person you're donating to will be in nearby operating rooms. Your surgeon will make a cut in your belly and divide your liver into two pieces. The other person will get about half. Your surgeon may also remove your gallbladder, which is connected to the liver. After the procedure, the surgeon will close the opening and you'll go to a recovery room.

What Happens When You Get a Liver?

Your surgeon will first remove your damaged liver. As soon as other surgeons remove part of the donor's liver, they will put it in you. They'll attach it to blood vessels and to the duct that carries bile out of your liver. The operation takes 4 to 8 hours.

Who Pays for the Surgery?

If you donate your liver, the health insurance of the person getting it should pay for your surgery and any care you need afterward. Your travel costs aren't covered, but some hospitals offer free or low-cost housing if you need to stay nearby for tests. You won't get paid for the time you take off from work, but you may be able to get sick leave or disability pay. You won't get money for donating your liver -- that's illegal.

How Long Is the Hospital Stay?

Whether you're getting or giving a liver, you'll spend 7 days or longer in the hospital after your surgery. You may be in the intensive care unit (ICU) for the first few nights. Then, you'll go to a transplant floor for the rest of your stay. The medical team will help you get out of bed and walk on the day after your surgery. You'll start on a diet of clear fluids. After a couple of days, you should be able to eat normal food again.

What Is Recovery Like?

For donors or those getting a liver, it usually takes about 6 to 8 weeks. You won't be able to work during this time. You'll have some pain, but your doctor will give you medicine to control it. Be careful not to lift anything heavy for about the first 3 months. Whether you donate or receive a liver, your new organ will start to grow right after the surgery. Within 2 months, it should almost be back to its normal size.

What Happens After Surgery?

Whether you donate or receive a liver, you'll see your doctor for regular checkups during the first month after the operation. Then you'll have appointments about once every 3 months, and after that once a year. Go back to your activities slowly, as you feel ready. Avoid alcohol for the first 6 months after your surgery. Ask your doctor which medicines are safe for you to take.

Questions to Ask Your Doctor

If you want to donate your liver or you need a new one, ask your doctor these questions:

• What tests will you do to see if the organ is a good match?
• What are the risks if I donate or receive a liver?
• What medicines will I need to take after the surgery?
• How often will I need to see you for follow-up visits after surgery?
• How will I know if I'm having complications?
• What should I do if I have problems after surgery?