Who Can Donate a Liver?

Medically Reviewed by Jennifer Robinson, MD on February 26, 2024
Written by Amanda Gardner
6 min read

If you want to donate part of your liver to someone who needs a new one, you'll need to check to see if you've got the right profile. The government and transplant centers have rules about who can and can't be a donor.

To get approved, you'll need a physical exam, medical tests, mental health checks, and a lot more. It might take 4 to 6 months for you to get the OK. Every transplant center has its own specific process, but there are some general guidelines and steps you can expect.

You're the only one who can decide to donate part of your liver. It's illegal for anyone to force you to do it. It's also against the law to sell organs.

Transplant centers always make sure that their donors are doing this of their own free will, and you'll need to sign a consent form. You have the right to back out at any time.

A 2019 survey by WebMD in collaboration with UPMC showed the top reason respondents gave for being a living donor is to save a life, especially of a loved one or friend. Younger people more often noted that it's unfair that someone who needs a new liver might not survive when they could save their life by becoming a donor.

About half of the respondents said they would consider being a donor because they realize they might need one someday themselves.

If you're a blood relative, it's more likely that your blood type will be a good match for the person getting part of your liver. Some transplant centers, though, let you donate part of your liver to someone you don't know who's on the organ transplant waiting list.

Most transplant centers want you to be between 18 and 60 years old, although the exact age range varies. The reason is that older donors tend to have more complications than younger ones. Transplant centers also consider children and teens to be too young to give the proper consent.

You don't have to have the exact blood type as the person who needs a new liver, but you need to be what's called "compatible." This can be figured out with a simple blood test. Here's how it works:

  • If you have Type O blood, you are a "universal donor" and can donate to anyone (although Type O liver recipients can only get organs from people who are also Type O).
  • If you are Type A, you can donate to those who are also Type A as well as Type AB.
  • Type B blood types can donate to other Type Bs and to Type ABs.
  • Type AB people can donate to those with that same blood type.

Your Rh factor (whether your blood type is "positive" or "negative") doesn't play a role.

Other blood tests will check how well your liver is working and confirm that you're in good health. You may need to go to a special lab to have your blood drawn, or you may be able to have these tests at your local hospital.

If you want to be a donor, your liver, kidneys, and thyroid need to be working right. Transplant centers also want to know that you don't have medical problems like these:

  • Liver disease, including hepatitis
  • Diabetes (or a strong family history of the disease)
  • Heart, kidney, or lung disease
  • Gastrointestinal disease, autoimmune disorders, neurologic disease, and certain blood disorders
  • HIV or AIDS
  • Cancer (or once had some types of cancer)
  • High blood pressure that's not under control
  • Current or long-term infections, including hepatitis C
  • Excessive use of alcohol or recreational drugs, including marijuana

You can't be a donor if you're obese or pregnant. You may also be disqualified if you take pain medications or drugs that are toxic to your liver.

To make sure you're healthy enough to donate, you'll have to have a general physical exam. You'll be asked many questions about your physical health and family medical history. In addition to a thorough exam by a doctor, you'll have tests that may include:

  • Electrocardiogram (EKG)
  • Chest X-ray
  • CT scan of your belly
  • Abdominal ultrasound
  • Urine test
  • Mammogram (for women over 40)
  • Colonoscopy (for men and women over 50)
  • Liver biopsy

The transplant center may order more blood tests or image scans. Sometimes, you're able to have all of these tests at a hospital near your home.

You'll need to get checked by a psychiatrist, psychologist, or social worker to make sure you don't have mental health issues, such as anxiety, that might affect your own recovery. They will ask you about behavior that puts you at high risk for infectious diseases. And they'll want to know that you have a good social, emotional, and financial support system lined up for the period after surgery.

You may also need to take either a psychiatric or psychological test.

Quitting tobacco 1-2 months before surgery can help lower the odds 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.

Many transplant centers prefer to do living-donor transplants between two people who are roughly the same size (by height and weight), although it's not a hard and fast rule.

If your health, blood type, and other factors show you could be a good donor candidate, you'll be asked to meet with a living donor team. This is a group of experts who will have your best interests at heart and that will explain how the transplant surgery works. They'll also want to make sure you're ready for how this process could affect you emotionally or financially.

Your team could include a:

  • Hepatologist (transplant doctor who treats the liver)
  • Nurse coordinator
  • Finance coordinator
  • Social worker
  • Living donor advocate
  • Nutrition expert

This is also a good time for you to ask questions or bring up concerns you may have. Your team can also put you in touch with someone who donated their liver in the past. That way, you can get a firsthand account of what it's like and get insights into the decision-making process that others went through.

After the tests and meetings are done, the transplant team will meet. They'll look at all these details about your health and decide if you're a good match for the recipient. If so, you'll get a date for surgery that works for both you and the person who will receive your liver.

If you're not a good match, doctors will tell you why. The recipient will only be told that you were "declined." It's up to you to decide whether to share more details with them.

The offer to become a living liver donor is an amazing act of kindness. It's also a big commitment. At any point in the process, if you want to change your mind, you're allowed to do so.

Your transplant team will respect your choice and keep your decision private. Many doctors will simply tell the person who needs a liver transplant that you are "no longer a good match." The recipient can then stay on the waiting list to get a liver from a deceased donor or try to find another living donor.