Pros and Cons of Living-Donor Liver Transplants

Medically Reviewed by Minesh Khatri, MD on November 16, 2022
3 min read

You probably have lots of questions if you’re faced with the decision to donate part of your liver or get one from a living donor. Just like any medical procedure, there are risks and benefits. Here are some of the things you should consider.

Pro: You’ll regrow the part you donated.

The liver is the only organ in your body that can regenerate, or regrow lost tissue. Your liver will start to work like normal 2-4 weeks after surgery. About 2 months later, it’ll be back to the size it was before the donation.

Con: Both sides can have complications.

Your chance of problems after surgery depends on how much of your liver you’re donating. As a donor, there’s a chance you could get an infection after surgery. It’s not common, but you could also have serious complications. These include:

  • Bleeding
  • Injury to the rest of your liver
  • Bile leak or fluid in your belly
  • A hernia (when part of an organ sticks out through an opening) where the doctor cut you

It’s rare, but liver donors sometimes end up needing a new liver themselves after donation.

If you get a living-donor liver transplant, there’s a chance your body won’t accept the new organ. You’re also at risk for:

  • Blood clots
  • A leaking or narrowed bile duct
  • Tumor
  • Infection

Pro: It improves your short-term outcome.

People who get a liver transplant from a living donor tend to have a higher rate of short-term survival than those who get their liver from a donor who has died. Doctors can’t say whether long-term survival rates are better for living-donor recipients. That’s because living-donor recipients are usually in better health than deceased-donor recipients at the time of surgery. They usually haven’t been waiting as long.

Con: Recipients take meds for life.

Along with other medications to help keep complications at bay, you’ll have to take immunosuppressant drugs for the rest of your life. Immunosuppressants keep your body from attacking your new organ. These drugs weaken your immune system, so you’re at a higher risk for infection when you’re on them.

Pro: You’ll have a faster recovery.

Living-donor recipients have shorter hospital stays after surgery than deceased-donor recipients. You’re also less likely to need a blood transfusion or dialysis.

Con: Recovery still takes time.

Liver transplant is a major surgery, for both the donor and the recipient. You’ll both need to stay in the hospital afterward. Right after surgery, you’ll both go to the intensive care unit (ICU) for monitoring. The donor can usually go home in 4-7 days. Recipients typically stay 1-2 weeks or longer. Your doctor will watch for signs of rejection during this time.

Even after you’re home, it may take a few more weeks to get back to normal. You may have some pain where the doctor cut you. If you’re a donor, recovery may take about 3-6 weeks. If you’re a recipient, it may take about 3-6 months. Everyone is different -- it depends on things like your age and overall health.

Pro: Insurance covers donation.

The recipient’s insurance should cover the biggest costs of liver transplant. These include:

  • Pretransplant evaluations
  • Surgery
  • In-hospital recovery
  • Follow-up care

Con: There are still some costs to consider.

You’ll need to think about how much other parts of the donation process will cost. These can include:

  • Travel expenses
  • Hotels stays for yourself or family before the surgery
  • Missed pay from time off work
  • Pain medications

Pro: You’ll have a shorter wait for a liver.

More than 17,500 people in the U.S. are on the waitlist for a new liver. A living-donor donation can come from a family or loved one. This means you’ll spend less time on the waitlist, if you even need to be on it at all. This lowers your odds of getting very sick from liver disease. It also improves your chance of a successful transplant and higher quality of life after surgery.