Liver donation is a medical procedure that offers a life-saving treatment for individuals with end-stage liver disease or certain liver cancers. This process involves transplanting a healthy liver, or a portion of one, into a recipient whose own liver is no longer functioning properly. A liver transplant can significantly improve health outcomes and extend lives.
Understanding Liver Donation
Liver donation can occur in two ways: through deceased donor donation or living donor donation. Deceased donation involves transplanting a liver from an individual who has passed away. This type of donation relies on the availability of suitable organs from a limited pool.
Living donor liver donation involves a healthy person donating a segment of their liver to a recipient while they are still alive. The human liver is unique among organs due to its remarkable ability to regenerate. Both the donated portion and the remaining part of the donor’s liver can grow back to nearly their original size and function within a few months. This regenerative capacity makes living liver donation an increasingly utilized option, offering a timely alternative to waiting for a deceased donor organ.
Who is Eligible to Donate a Liver?
Becoming a living liver donor involves meeting criteria to ensure donor safety. Donors are healthy adults between 18 and 60 years old. Candidates must not have significant chronic illnesses such as heart disease, kidney disease, diabetes, or active infections.
The donor’s liver must be healthy, without underlying conditions like fatty liver disease or hepatitis. Body Mass Index (BMI) is also a consideration, with many programs requiring a BMI below 32 to minimize surgical risks. Blood type compatibility is often preferred, though donation may be possible with different blood types in some cases.
A psychological evaluation assesses the donor’s understanding of the procedure, their motivations, and their support system. This ensures the decision to donate is voluntary and well-informed. Lifestyle factors are also reviewed, with abstinence from alcohol and illicit drugs required.
The Living Donor Evaluation and Surgical Process
The process begins with an initial screening, which includes phone interviews and basic health questionnaires. If this preliminary assessment suggests suitability, the potential donor undergoes a comprehensive medical evaluation. This phase involves detailed blood tests to assess overall health and liver function, along with imaging studies such as CT scans and MRIs to map the liver’s anatomy and size. Cardiac assessments and other organ function tests may also be performed to ensure the donor is medically fit for major surgery.
A key component of the evaluation is the psychological and social assessment, involving interviews with mental health professionals and social workers. This step confirms informed consent, evaluates emotional readiness, and identifies a support system for post-surgery recovery. An independent donor advocate, separate from the recipient’s medical team, is also involved to ensure the donor’s best interests are prioritized throughout the process.
Once approved, the surgical procedure, known as a hepatectomy, involves removing a portion of the donor’s liver. The specific segment removed depends on the recipient’s needs, ranging from 20% to 60% of the liver. This major surgery can last several hours, during which the removed liver portion is immediately prepared for transplantation into the recipient.
Life After Liver Donation for the Donor
Following a living liver donation, donors spend about five to seven days in the hospital for post-operative recovery. Pain management is provided, and donors are encouraged to begin walking to aid recovery. The initial recovery at home can take several weeks, with most donors returning to normal activities within six to eight weeks. Fatigue is common during this period, and dietary considerations are part of the recovery plan.
The liver’s regenerative capacity is a key aspect of donation. The remaining liver portion in the donor begins to grow almost immediately after surgery, returning to nearly its original size within two to three months. Full regeneration to 90% of the original size can occur within a year, ensuring normal liver function for the donor.
Long-term follow-up is a standard practice, with regular check-ups and lab tests scheduled with the transplant team for several years to monitor the donor’s health and liver function. While living liver donation is generally safe, there are potential, though rare, surgical risks such as infection, bleeding, or blood clots, similar to any major operation. Liver-specific complications like bile leakage or bile duct problems can also occur.