Yes, it is possible to receive a liver transplant from a living donor. This procedure involves removing a portion of a healthy person’s liver and transplanting it into a recipient whose liver is no longer functioning properly. The liver’s remarkable ability to regenerate allows partial livers in both donor and recipient to grow back, often reaching nearly their original size and function within a few months. This regenerative capacity makes living donation a viable option for individuals in need of a new liver.
The Living Donor Liver Transplant Process
The journey for both donor and recipient begins with thorough medical, psychological, and social assessments. These evaluations ensure their suitability and readiness for the significant surgery ahead.
Once approved, the surgical procedures for the donor and recipient typically occur simultaneously. The donor’s surgery, a partial hepatectomy, involves removing a segment of their liver, usually a lobe, ranging from 25% to 65% of its mass. This operation generally takes four to six hours. Surgical teams ensure enough liver remains in the donor for safe regeneration.
Concurrently, the recipient’s diseased liver is removed, and the donated segment is implanted. Surgeons carefully connect the blood vessels and bile ducts to the new liver, a complex process that can take six to twelve hours. Immediately following surgery, both are moved to intensive care for close monitoring and initial recovery.
In the post-operative period, the donor typically remains in the hospital for four to seven days. The recipient’s hospital stay is often longer, generally around seven days. This initial recovery focuses on pain management, monitoring for complications, and ensuring the transplanted liver functions effectively.
Donor and Recipient Eligibility
Becoming a living liver donor requires meeting specific health and compatibility criteria. Donors are typically between 18 and 60 years old, though some centers may consider slightly younger or older candidates on a case-by-case basis. They must be in good overall physical and mental health, with no significant medical problems like heart or kidney disease, active infections, or ongoing cancer. A body mass index (BMI) less than 32 or 33 is generally required, as obesity can increase surgical risks and indicate fatty liver disease.
Blood type compatibility is usually a primary consideration, although some programs offer paired exchange transplants for incompatible pairs. The donor’s liver health is also thoroughly assessed to ensure it is free from conditions like hepatitis or cirrhosis. Psychological readiness and a clear understanding of the donation’s risks and benefits are also evaluated, ensuring the decision to donate is voluntary and without coercion.
For recipients, eligibility centers on the severity of their liver disease and their overall health status. Individuals with end-stage liver disease or certain liver cancers are candidates. They must be medically stable enough to withstand major surgery and not have other severe medical conditions that would compromise the transplant’s success. Psychological and social support systems are also considered, as long-term adherence to post-transplant care is important for a successful outcome.
Advantages of Living Donor Liver Transplants
Living donor liver transplants offer several distinct advantages compared to deceased donor transplants. A primary benefit is the significantly reduced waiting time for a new liver. This allows recipients to undergo transplantation sooner, often before their liver condition deteriorates further, which can lead to better outcomes. More than 17,500 people are on the waiting list for a liver transplant, and thousands die or become too sick each year while waiting for a deceased donor organ.
The ability to schedule the surgery in advance is another advantage. This planned approach allows both donor and recipient to prepare physically and mentally, reducing the urgency and stress of emergent deceased donor transplants. This planned timing also allows for optimal medical preparation.
Living donor livers are typically of excellent quality because donors are extensively evaluated and healthy. This often results in better recipient outcomes, including shorter hospital stays and fewer complications. Furthermore, the cold ischemia time—the period the liver is without blood supply and artificially preserved—is significantly shorter in living donor transplants, as the organ is transferred directly from donor to recipient, contributing to improved graft function.
Life After Living Donor Liver Transplant
Following a living donor liver transplant, both donor and recipient embark on a recovery journey. For the donor, the hospital stay typically lasts four to seven days. Most donors can return to light activities within three to six weeks and resume full activities, including work, within six to eight weeks. The donor’s liver typically regenerates to nearly its original size within two to three months. Long-term follow-up appointments monitor the donor’s health and liver function.
For the recipient, immediate post-transplant care involves a hospital stay of around seven days. A key aspect of the recipient’s long-term care is taking immunosuppressant medications for life. These medications prevent the immune system from rejecting the new liver. Doses are carefully managed and may be reduced over time, but some level of immunosuppression is always required.
Recipients will have regular follow-up appointments and blood tests to monitor liver function, medication levels, and overall health. Many recipients can return to work within a few months, though lifestyle adjustments may be necessary. This includes avoiding certain medications and being vigilant for signs of infection or rejection due to a suppressed immune system.