Living Liver Transplants: Pairing Donor and Recipient

Medically Reviewed by Minesh Khatri, MD on October 31, 2021
4 min read

If you want to donate part of your liver to someone who needs a transplant, the two of you must be a good match. To make sure surgery goes well for both of you, doctors look at things like blood type, body size, and age.

Donating part of your liver can be lifesaving for the recipient. Instead of a long wait for a deceased donor, the person who needs a new liver can get a transplant relatively quickly.

The whole process is made possible by the liver's special power to regrow. If you're the donor, when you donate part of your liver, over time the portion that remains will grow into a full-sized liver. The same is true for the recipient who gets part of a new, healthy liver from a donor.

A living donor doesn't have to be a close family member. If you want to be a donor, you might be a distant relative, friend, neighbor, or co-worker of the person who needs a new liver.

Keep in mind, though, that some transplant centers won't let you donate a liver if you're a stranger to the recipient.

According to a WebMD survey in collaboration with UPMC, 70% of respondents say they'd be willing to be a living donor for someone they know.

The survey also shows that people prefer to ask a family or friend to be a living donor if they ever needed a new liver. Less than one-quarter of survey respondents say they would be willing to ask someone who isn't a family member or friend to donate a liver.

Some centers require that your blood type be a match with the recipient. For example, these types make good matches:

  • Type O. If you have this type, you can donate to people who have type A, AB, B, or O.
  • Type AB. You can donate to someone who has type AB.
  • Type A. You can donate to someone who is either type A or AB.
  • Type B. You can donate to people who have type B or AB.

Unless you plan to donate your liver to a child, your body size should be roughly about the same as the adult who will get part of your liver.

You must be healthy to donate your liver. It's crucial that you be free of cancer, organ diseases like liver or heart disease, hepatitis, HIV, and any active or long-term infections.

Your blood pressure should also be normal.

Being a living donor is a big commitment. You'll need to have no history of major mental health problems.

You can't be a donor if you have a substance use disorder. You also can't donate if you have an alcohol addiction or drink heavily.

The age range of donors varies for different transplant centers, but in general you must be between 18 and 60.

A liver from someone who's under 40 may offer a better outcome for the recipient. As people get older, their liver can become more fatty and they may have more scar tissue.

Transplant centers have weight requirements. Depending on the center, your body mass index (BMI) will need to be less than 33 to 35.

You should never feel pressured into being a donor. You also can't go through this process if someone has promised you money. It's against the law to buy or sell organs.

Every living donor should know how the transplant process might affect their daily life and be prepared for some changes. Some things to think about:

Health insurance. When you're a liver donor, your medical costs are usually paid by the health insurance of the person who receives your liver. That includes the evaluation process, surgery, hospital stay, follow-up care, and treatment of any problems that come up because of the transplant. Your own insurance pays for any tests or treatments you need that are separate from the transplant.

Work. You'll need to think about lost wages once you take time off after surgery to donate a liver. If you have a physically demanding job, keep in mind that the transplant process will affect your strength and energy level for a while. You'll want to talk to your boss about how to deal with that.

Travel. If you don't live near the person who will receive your liver, you may need to pay for transportation costs and a place to stay each time you meet with the doctor.

As you go through tests and interviews to see if you're a good match to be a living liver donor, all the information you share is kept private. If you're not the right fit or change your mind, the recipient is only told that your organ was declined. It's your choice whether to share the exact reasons.