In living donor liver transplantation, a piece of liver is removed from a living donor and transplanted into a recipient. The procedure, performed after the diseased liver has been removed, is possible because the liver regenerates or grows. The liver's unique ability to regenerate itself - combined with technological advances - allows more people to be donors.
Regeneration happens over a short period, possibly days to weeks and certainly within eight weeks. When surgeons remove a piece of the donor's liver, the part that remains grows back quickly to its original size.
More than a decade ago, surgeons around the world began performing living donor transplants using adult donors for children who needed transplants. Surgeons at UCSF Medical Center have performed these transplants between adults and children since 1992.
Surgeons outside the United States, mostly in countries where cadaveric organs are unavailable, expanded the technique to adult recipients in the mid-1990s. Since then, many centers throughout the world have begun to perform living donor liver transplants between adults. UCSF performed its first adult-to-adult living donor transplant in January 2000 and has since performed more than 50 of these operations.
Waiting for a Liver
At UCSF Medical Center, the majority of organs for transplantation are obtained from people who have died and whose families have given permission for their organs to be donated. But today, an increasing number of liver transplants are performd with portions of livers donated by a living relative or friend.
Nationally, there are more than 17,500 patients on the waiting list, with more added each day. Almost 5,000 patients receive transplanted livers every year, but more than 1,700 patients die each year while on the waiting list.
Living donors not only reduce the waiting time, but they improve the chance for transplant success. Patients who receive transplants from living donors can better prepare for their surgery, knowing well in advance when the transplant will take place. Also, the liver itself is "fresher" because donor and recipient are in nearby operating rooms and the donated liver portion is transported within minutes.
Becoming a Donor
Potential donors must meet certain basic requirements to be considered. First, the donor must want to make this gift. During the evaluation process, we want to make sure you are not being coerced to do this in any way. You do not have to be a relative of the recipient, as long as you are a good donor match in other respects such as blood type.
Donors, however, cannot be pregnant and cannot be overweight, although overweight candidates who lose weight may be considered.
Donors should be:
- 18 to 55 years of age.
- In good health with no major medical or psychiatric illnesses.
- A non-smoker for at least six weeks prior to surgery.
- Able to understand and comply with instructions for surgery preparation and recovery.
A living donor doesn't have to be a blood relative of the liver recipient but you must have a compatible blood type. You must be in good health and be motivated to donate for altruistic reasons. If live donation is a feasible option for a patient, a donor evaluation will be performed after the recipient's testing is completed. If, after testing the donor, the transplant team determines the donation can be performed, a surgery date is scheduled for both the donor and recipient. This process usually takes up to four to six months.
Once your blood type is confirmed, you will receive a detailed confidential questionnaire about your family medical history, lifestyle and other information. The evaluation includes a series of tests to check your blood type and overall health. Tests include:
- Chest X-ray
- Electrocardiogram (EKG or ECG)
- Abdominal ultrasound
A doctor who is not a member of the transplant team will complete your medical evaluation and serve as the "donor advocate" doctor throughout your surgery and recovery