Pros and Cons of Living-Donor Liver Transplants

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

If you need a new liver, or you want to give away part of yours, there's a lot to think about before you decide to go ahead with transplant surgery. Like any procedure, there are risks and benefits. Learn as much as you can about how it's done, and weigh the pros and cons.

If you're going to be a donor, you may worry that removing part of your liver will hurt your health. But you can lose up to 75% of it, and it will grow back to its original size quickly -- and work just fine when it does.

"The liver regenerates almost immediately after surgery, and will have reached its near normal size by 6-8 weeks or so," says Helen S. Te, MD, medical director of the Adult Liver Transplant Program at the University of Chicago Medical Center. Livers are the only organ that can do this, and it's what makes living-donor transplants possible.

"The donor can [get] medical complications such as bleeding, bile leaks, infections, or blood clots," Te says.

You could also get a hernia when you're a donor. And it's rare, but the part of your liver that's left after you donate could stop working, which can be life-threatening.

If you receive a new liver, there's a risk you could get a narrowed bile duct, which a doctor would have to treat later.

Since livers from living donors are outside the body for a shorter amount of time than ones that come from someone who has died, they tend to "take" better, Te says.

But whether you get a liver from a living donor or someone who's died, the results are the same after the short term is over, Te says."[Livers from someone who has died] may last just as long as living-donor organs, depending on how the recipient's medical course goes," she says.

Whether your liver comes from a living donor or not, it will be a big boost to your health. But your new liver is also a stranger to your body. You'll have to take drugs that keep your immune system -- your body's defense against germs -- from treating the new liver as an invader that needs to be attacked. These medications sometimes come with side effects, like high blood pressure, diabetes, and high cholesterol.

Part of your routine after surgery will be to meet with health experts who can teach you how to go on the offense with your health. "You'll be counseled on lifestyle changes that are personalized to your needs, including things like dietary changes," Te says.

Most living-donor transplants happen between family members or close friends. If you know someone who is willing and able to give you part of their liver, you may be able to get a transplant more quickly than you would if you have to wait until a liver becomes available from a donor who has died. That often means you get your surgery done before you get extremely sick from your liver disease.

Getting a new liver from someone you know also gives you more say over when you schedule your surgery. You and your donor will have a chance to figure out when an operation fits best into both of your lives. 

You may spend some time in an intensive care unit after you get your new liver, and up to 10 days in the hospital overall.

If you're a liver donor, it also takes time to recover. "Donors are hospitalized for about a week after the surgery and may take about 2 to 3 months to fully recover," Te says.

Whether you're a donor or the person getting the liver, you'll need to avoid alcohol, recreational drugs, and contact sports after the transplant.

Normally, the health insurance of the person who is getting a new liver covers the expense of the donor, including pre-transplant evaluations, surgery, in-hospital recovery, and follow-up care. If you're the donor, though, you or your insurance company may have to pay for pain medications, post-surgery care, and any travel costs for getting to the hospital where the operation takes place.

Whether you get the liver or give it, you may hurt at the spot where the surgeon cuts into your body. It's usually a little worse for the donor, Te says.

"Transplant recipients tend to have less pain due to the use of high-dose steroids to prevent rejection [of the new liver], which also masks the pain," she says. Your doctor will give you pain medication, but it could be up to 4 weeks before your discomfort goes away.

In the U.S., there are more than 17,500 people on a waiting list for a new liver. There aren't enough livers to go around from donors who die. If you become a living donor, you help free up a liver for someone else on the waiting list. And a successful transplant gives the person who gets your new liver more years of life.

Show Sources


Lahey Hospital & Medical Center: "Pros and Cons of Liver Organ Donation."

Helen S. Te, MD, associate professor of medicine, University of Chicago Medicine; director, Adult Liver Transplant Program, University of Chicago Medical Center, Chicago.

University of California San Francisco Medical Center: "Liver Transplant Patient Handbook."

Mayo Clinic: "Liver Transplant."

American Transplant Foundation: "Living Liver Donation."

University of Wisconsin Hospitals and Clinics Authority: "Live Liver Donation Frequently Asked Questions."

Johns Hopkins Medicine Comprehensive Transplant Center: "Living Donor Liver Transplant."

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