Living liver donation allows a healthy person to give a portion of their liver to someone with liver failure. This complex procedure involves transplanting a segment of liver tissue from the donor into the recipient. The feasibility of this life-saving surgery relies on the donor’s overall health and the liver’s unique biological properties. Extensive screening is required to ensure donor safety and the best possible outcome for the recipient.
The Liver’s Capacity for Regeneration
The ability of a living person to donate a part of their liver depends entirely on the organ’s unique power of regeneration. The liver is the only solid internal organ in the human body that can regrow itself to nearly its original size and function. This biological process is known as compensatory growth.
After a portion of the liver is surgically removed, the remaining liver cells begin to rapidly enlarge and multiply. This regrowth is driven by signals from growth factors and hormones in the bloodstream. Within the first six to eight weeks following the donation, the donor’s remaining liver typically returns to approximately 80% of its initial volume.
Complete restoration of the liver’s pre-donation size usually occurs within a few months, continuing slowly over the course of a year. The transplanted portion of the liver in the recipient also rapidly regrows to a size adequate for the new host’s body.
Medical and Psychological Requirements for Donors
The screening process for a potential living liver donor is extensive and rigorous, prioritizing donor safety. Donors are typically required to be between the ages of 18 and 60, though specific age ranges vary between transplant centers. They must be in excellent overall physical and mental health to withstand a major surgical procedure.
A donor candidate must not have any pre-existing conditions that could compromise their recovery or the health of the donated liver. This includes a history of liver diseases like hepatitis or cirrhosis, or significant systemic conditions affecting the heart, lungs, or kidneys. Screening also checks for an active infection, an ongoing malignancy, or a body mass index (BMI) that exceeds a specific limit, often around 32, to minimize surgical risk and rule out fatty liver disease.
Physical evaluation includes numerous blood tests to assess liver function, screen for transmissible diseases like HIV, and determine blood type compatibility. Imaging studies, such as a CT scan and MRI, are performed to map the liver’s anatomy and calculate the exact volume of the segment that will be removed. The goal is to ensure the remaining portion of the donor’s liver is sufficient to sustain their own health.
Psychological screening is conducted by a dedicated independent team focusing on the donor’s well-being. This evaluation confirms the candidate understands the risks of the surgery and is making a voluntary decision without coercion or undue pressure. The donor must be emotionally stable and possess adequate social and financial support systems to aid in their recovery period.
The Donation Procedure and Recovery Timeline
The living liver donation surgery involves removing a segment of the liver in an operation that typically lasts four to seven hours under general anesthesia. The specific portion removed depends on the recipient’s size and needs. A smaller segment, often the left lobe, is taken for a child, while a larger portion, usually the right lobe, is necessary for an adult recipient. Removing the right lobe, which is about 40 to 60% of the total mass, increases the complexity and recovery period for the donor.
The procedure requires a large abdominal incision, though some centers may utilize minimally invasive techniques. During the surgery, the appropriate segment is carefully dissected, and its blood vessels and bile ducts are disconnected before the segment is removed for immediate transplantation into the recipient. For donations involving the right lobe, the donor’s gallbladder is usually removed as well, since it is directly connected to that section of the liver.
Living liver donation carries risks, including an allergic reaction to anesthesia, bleeding that may require a blood transfusion, and the potential for a wound infection. Specific complications related to the liver include a bile leak from the cut surface or an issue with the bile ducts. The risk of death for the donor is a serious possibility, with rates typically estimated to be around one in every 300 to 500 procedures.
Following the operation, the donor is closely monitored, often spending the first night in an intensive care unit. The typical hospital stay is approximately five to seven days, during which time the medical team manages pain and ensures the donor is mobile. Donors are advised to avoid lifting anything heavier than ten pounds for at least six weeks to prevent incisional hernias.
Fatigue is common in the weeks following the surgery as the body expends energy to regenerate the liver tissue. Most donors can return to work and resume most pre-donation activities within two to three months. Full energy levels and a complete return to normal physical activity often require a recovery period of four to six months. Donors are required to have long-term follow-up care, including checkups and lab work, for up to five years to monitor their health and the regeneration of their liver.