Living liver donation offers a life-saving opportunity for individuals facing severe liver disease or liver failure. This procedure involves a healthy person donating a portion of their liver to a recipient. This transplant provides an alternative to waiting for a deceased donor organ, which can be a lengthy and uncertain process given the high demand. Living donation can significantly reduce wait times and improve outcomes for recipients.
The Liver’s Unique Ability
The liver possesses a remarkable capacity: it can regenerate. Unlike other organs that scar after injury, the liver regrows to nearly its original size and function. This regeneration is not about new lobes growing, but rather the remaining liver tissue enlarging to compensate for the removed section. This capability makes living liver donation feasible.
As little as 10% of the original liver mass is needed for the organ to regenerate. Following partial removal, the liver regrows to about 90% of its original volume within weeks to months.
The Living Liver Donation Process
Living liver donation involves rigorous steps to ensure donor safety and suitability. Potential donors undergo a comprehensive evaluation, including extensive medical tests, imaging studies, and psychological assessments. This screening confirms the donor’s overall health, assesses liver condition, and determines anatomical compatibility with the recipient.
If approved, the donor undergoes a partial hepatectomy, where a segment of their liver is removed. This segment, often a lobe or smaller portion depending on recipient needs, is immediately transplanted. Donors remain in the hospital for five to seven days for recovery and monitoring.
Why Re-Donation is Not Possible
Despite the liver’s regenerative capacity after a single donation, re-donation is not medically advised. While liver tissue regrows to nearly its original volume, the intricate network of blood vessels and bile ducts does not regenerate in a way that allows for a second safe donation. The initial surgery alters the liver’s vascular and biliary architecture, making subsequent surgical interventions more complex and risky. Attempting a second donation would pose significant risks to donor health, including surgical complications, compromised liver function, and potential long-term health issues. Medical guidelines and ethical considerations prioritize donor well-being, advising against multiple liver donations.
Donor Health and Recovery
Following a single living liver donation, individuals experience a recovery period allowing them to return to a healthy life. Most donors can care for themselves at home about a week after hospital discharge. Incision wounds heal within two to six weeks, and donors can resume regular activities, including returning to work, within six to eight weeks.
The liver continues to regenerate, reaching its near-full size within two to three months. Post-operative follow-up care is important, involving regular check-ups and laboratory tests over the first year to monitor donor health and liver function. While complications are rare, they can include bile leakage, wound infections, or blood clots. The long-term health and quality of life for most living liver donors are comparable to that of the general population.