Living liver donation is an established medical procedure where a segment of a healthy person’s liver is surgically removed and transplanted into a recipient. This process offers a life-saving alternative to waiting for a deceased donor organ. The unique ability of the liver to regrow makes this donation possible for both adults and children suffering from end-stage liver disease. This option allows recipients to receive a transplant sooner, potentially preventing further decline in health while on the waiting list. This information details the stringent requirements, comprehensive evaluation, surgical specifics, and recovery process involved in becoming a living liver donor.
Eligibility Requirements for Donors
A potential living liver donor must meet strict physical and mental health standards to ensure the safety of the donation. Donors must generally be between the ages of 18 and 60, though age limits can vary. A crucial physical requirement is having a body mass index (BMI) of less than 32, or sometimes less than 30, to reduce surgical risks.
Donors must be free from any significant chronic medical conditions that could compromise their recovery, including heart disease, diabetes, active cancer, or major kidney or lung disease. The donor’s liver itself must be in excellent condition, meaning no history of liver disease, such as hepatitis, cirrhosis, or significant fatty liver disease.
Beyond physical health, psychological stability is necessary. The decision to donate must be entirely voluntary and free from coercion or financial incentive. The potential donor must possess a clear understanding of the procedure, including the risks and commitment involved. Transplant centers look for individuals who have a robust support system to aid in their recovery.
The Donor Evaluation Process
The evaluation process is a multi-step screening designed to confirm the donor’s physical and psychological readiness for surgery. It begins with initial screenings like blood typing for compatibility and an in-depth review of the medical history. Comprehensive medical tests follow to assess overall organ function and liver anatomy.
Detailed imaging studies, such as CT scans and MRIs, are performed to map the liver’s vascular structure and calculate the volume that can be safely removed. Liver function tests and cardiac screenings, including an EKG and possibly a stress test, ensure the donor’s remaining liver and heart can handle the stress of surgery and recovery. The transplant center also conducts a thorough psychosocial evaluation with a social worker or psychiatrist.
A central part of this phase is the involvement of an Independent Donor Advocate (IDA), whose sole responsibility is to protect the donor’s interests. The IDA is separate from the recipient’s medical team and ensures the donor is making a fully informed and uncoerced decision.
Surgical Procedure and Liver Regeneration
The living liver donation surgery involves removing a portion of the donor’s liver. For adult-to-adult transplants, this is typically the larger right lobe (approximately 60% of the liver). For donation to a child, a smaller segment, often the left lateral section (about 20% of the liver), is removed. The specific segment is chosen based on the recipient’s needs and the donor’s safety, ensuring the donor retains sufficient liver volume to function normally.
The remarkable ability of the liver to regenerate is what makes this procedure possible, as it is the only organ that can fully regrow. Liver cells, or hepatocytes, respond to the loss of tissue by entering a phase of rapid cell division known as hyperplasia. This process begins almost immediately after the operation, restoring the organ’s functional capacity.
The donor’s remaining liver typically returns to nearly its original size and volume within six to twelve weeks post-surgery. The transplanted segment also grows quickly within the recipient, restoring normal liver function.
Risks and Post-Donation Recovery
Living liver donation is considered a major operation and carries both short-term surgical risks and a small risk of serious complications. General surgical risks include infection, bleeding, and the potential need for a blood transfusion. Specific risks involve bile leakage from the cut surface of the liver, which may require additional procedures.
The risk of donor mortality, while low, is a serious consideration and is estimated to be around 0.2% in worldwide surveys. Minor complications, such as wound issues or intestinal problems, occur in a significant percentage of donors. Long-term issues can include chronic pain, abdominal discomfort, and incisional hernias.
The typical hospital stay for a donor is between five and ten days following the operation. Most donors return to non-strenuous daily activities within a week of being discharged. A return to work and normal activities is generally possible within four to eight weeks, though full physical recovery can take up to six months. Transplant centers require long-term monitoring, with follow-up appointments scheduled regularly during the first year to ensure the donor’s full recovery.