A liver transplant surgery is a procedure to remove your liver and replace it with a healthy liver. It’s done when your liver stops working properly due to disease or injury.
Most liver transplants use a liver from a deceased person. In this case, the entire liver is removed from that person.
Sometimes, though, the liver is taken from someone who is alive. If this occurs, the surgery is called a living donor liver transplant or a live donor liver transplant.
In this case, the whole liver is not removed from the donor, because then they will not have a liver. Instead, only a piece of their liver is removed.
Here’s what the procedure involves, who it’s good for, and the potential risks for donors and recipients.
In general, a live donor liver transplant involves the following steps:
Before the procedure
Before the surgery, the living donor will complete various medical tests to make sure they’re a good candidate. These medical tests will also monitor the recipient’s health before the procedure.
The recipient will also need to complete various medical tests. During this time, doctors will determine how much of the donor’s liver you will need.
The surgery will be scheduled 4 to 6 weeks in advance.
During the procedure
There are two parts to a living donor liver transplant. The first part involves removing part of the donor’s liver, which can take 4 to 6 hours. The second part involves putting that piece of liver into the recipient, which can take 6 to 12 hours.
Typically, the procedure includes the following steps:
- The donor is given general anesthesia and their abdomen is cleaned.
- The surgeon creates an incision across the donor’s abdomen.
- Next, they remove a portion of the liver.
- The surgeon closes the incision and the recipient goes to the recovery room.
- The recipient is given general anesthesia and their abdomen is cleaned.
- The surgeon creates an incision across the recipient’s abdomen
- They cut the liver’s attachments and remove the damaged or injured part.
- Next, the surgeon attaches the recipient’s veins, arteries, and bile ducts to the donor’s liver part.
- The surgeon closes the incision.
After the procedure
Right after the procedure, the donor will go to the recovery room. They will stay in the hospital for about 7 days. During this time, the medical team will monitor their vital signs.
The recipient will go to the intensive care unit right after the surgery. Here, they’ll be given immunosuppressants to reduce the risk of complications with the new liver.
Once the recipient is stabilized, they’ll be moved to a regular room. They’ll stay in the hospital for about 2 weeks.
After the procedure, the donor’s liver will grow back. The recipient’s new liver will also grow back to a standard size.
Before a live donor liver transplant is performed, both the donor and recipient need to meet certain criteria.
Donors
A potential donor needs to complete a medical and psychological evaluation. This will be done by various medical professionals.
The evaluation will ensure that the donor is healthy enough to donate a piece of liver.
Potential donors need to:
- be 18 years or older
- have good physical and mental health
- not be involved in current drug or substance use
- have a compatible blood type with the recipient
- have healthy liver and kidney function
- have no history of certain health issues, including active cancer
- understand the benefits and risks of donating
A live liver donor does not need to be related to the recipient.
Recipients
A live donor liver transplant is not ideal for everyone who needs a liver transplant.
Good candidates for the surgery include those who:
- have irreversible liver disease or injury
- also qualify for a deceased donor liver transplant
- have a high chance of surviving the surgery and recovery period
- do not have severe portopulmonary hypertension (pulmonary arterial hypertension associated with portal hypertension)
In the United States, there’s a shortage of livers from deceased people. As a result, there are more people waiting for a transplant than there are available livers.
However, a live donor liver transplant can significantly reduce the waiting time. This has several benefits:
- lower risk of the recipient’s liver disease getting worse
- faster recovery time
- better long-term outcomes
- reduces liver transplant waitlist
Additionally, the procedure makes it possible for living relatives to donate. They’re more likely to have a compatible blood type, so they’re often a good match.
Live donor liver transplantation vs. cadaveric transplantation
Compared with a deceased donor liver transplant, a live donor surgery reduces the waiting time for a liver transplant.
However, there are potential complications. Some people might be more likely to experience these complications than others.
The best option depends on your specific condition and overall health status. Your medical team can determine which is the best surgery for your situation.
When performed by an experienced surgeon, a live donor liver transplant can be highly effective.
Compared with deceased donor liver transplants, live donor transplants have:
- a shorter hospital stay
- lower risk of intraoperative blood transfusion (recovering blood lost during surgery and re-infusing it into the person being operated on)
- lower risk of post-transplant dialysis
A live donor live transplant presents potential risks for both the recipient and donor.
Risks to the recipient
In recipients, potential risks include:
- biliary complications (bile leaks and biliary strictures)
- bleeding
- blood clots
- bacterial infection
- retransplantation
- portal vein thrombosis
- rejection of the donated liver piece
- mental confusion
- seizures
Compared with deceased donor liver transplants, the complications are less serious in live donor transplants.
Risks to the donor
About
- biliary complications (bile leaks and biliary fistulas)
- bacterial infections
- hernia
- blood clots
- bleeding
- nausea
There’s a higher risk of complications when the donated piece comes from the left lobe of the liver.
The cost of a live donor liver transplant depends on many factors, including your:
- age
- region
- hospital
- health status
In 2017, the average cost of a liver transplant was
Health insurance typically pays for a liver transplant. That’s because it’s a medically necessary procedure.
After the surgeon removes a piece of the liver, the donor may expect to fully recover in 3 to 6 weeks.
The recipient may expect to recover in 3 to 6 months.
During this time, recipients need to take medications to prevent complications and support their new liver. They’ll also need to regularly visit the doctor, who will monitor their health and progress.
According to the Organ Procurement and Transplantation Network, the national survival rate for living donor transplants from 2008 to 2015 was:
- 88% 1 year after the surgery
- 82% 3 years after the surgery
- 77.3% 5 years after the surgery
Here are common FAQs about live liver donor transplants:
What is living donor liver transplantation?
A living donor liver transplantation is when you get a portion of your liver from a living person. The piece of liver is removed from the person, then implanted into your body.
How long have living donor liver transplant surgeries been performed?
Living donor transplant surgeries have been performed since the 1980s. They were created because of the liver shortage for children under age 2. The surgery is now available for both children and adults.
How can I become a living liver donor?
To become a living liver donor, you’ll need to apply at a transplant center. You can apply online on the center’s website. After you apply, a medical team will perform a comprehensive evaluation to determine if you’re a good candidate.
Can you donate part of your liver to someone you don’t know?
You can donate a part of your liver to someone you don’t know. This is called a non-directed donation.
A liver transplant is a surgery to replace your liver with a healthy one. If the piece of liver comes from a living person, it’s called a live donor liver transplant.
This type of procedure can shorten the waiting time for a liver transplant. It also has a faster recovery time and better outlook than deceased donor liver transplants.
As with all surgeries, the donor and recipient need to meet certain requirements. A team of doctors can determine the best candidates for the procedure.