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:
- 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
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.
RAM SUBRAMANIAN: After a liver
it is really important
to be taking
your anti-rejection medications.
The new liver is a foreign organ
to the body
and one's immune system
recognizes that organ as foreign
so it has the potential
to reject that organ.
So the anti-rejection meds
are targeted at preventing
These anti-rejection medications
are targeted at blocking
those immune mechanisms that can
potentially cause rejection
of the new liver.
So the anti-rejection
medications are given
intravenously at the time
and after that, they are given
by capsule so it is a readily
administered form of medicine.
The risk of rejection
is maximum right
in the first six months
to a year--
so that is when we check
the liver enzymes regularly.
In fact, in the first couple
of months, we check their labs
even three times a week.
The good news is that as they
move farther and farther away
from liver transplantation,
the risk of rejection decreases,
so the frequency of labs
decreases as well.
Also, the amount
of immunosuppression that we
need to give them also
can be weaned over time
because the risk of rejection
It never goes to off
but it still can be decreased
The anti-rejection meds that we
have at our disposal do
have side effects.
So as you block
the immune system, you increase
the risk of developing
infections as well,
and that is why we are very
vigilant about watching
for infection complications
in these patients.
So they have any symptoms,
such as a cough, abdominal pain,
we have a very low threshold
to screen them
for infectious complications.
is that these medications can
have effects on different organ
independent of infection.
It can commonly cause kidney
It can cause neurologic or brain
It can increase the risk
of high blood pressure.
So even though these medications
are very effective in preventing
rejection, we also have to watch
for these other complications
that comes as a side effect
of these medications.
One of the remarkable things
about a liver and liver
is that it can be lifesaving
and provide a recipient
with many more years of life.
For example, I saw somebody
in clinic yesterday who was
25 years post-liver transplant.
An important requirement
for achieving that degree
of success with liver
transplantation is the patient
needs to be compliant
with their anti-rejection
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
- 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.