Living Liver Donation

Living liver donation is a procedure in which a healthy individual donates a portion of their liver to a recipient suffering from liver disease or liver failure. Since the liver has the unique ability to regenerate, both the donor and liver transplant recipient can expect their livers to regain function over time.

To be a living liver donor, you must meet the following criteria:

• Be between 18 and 60 years old
• Be in good physical and mental health
• Have a compatible blood type with the recipient
• Have a liver size sufficient for donation
• Be free of significant medical conditions such a liver disease, diabetes, or heart disease
• Undergo psychological screening to ensure readiness for donation

Living donors play a crucial role in addressing the growing need for liver transplants, providing hope and improved health for many individuals facing liver failure or liver disease.The wait time for a patient who needs a new liver can virtually be eliminated by a living donor liver transplant.

Living-related donors: Donors are healthy blood relatives of the patient requiring a transplant. The donor can be a:

• Family members such as a twin, sibling or parent
• Child over 18 years of age
• Other blood relatives (half-sisters, half-brothers, nieces, nephews, aunts, uncles, cousins)

Living unrelated or emotionally-related donors: Donors are not blood relatives and usually do not share tissue similarities with the recipient. The donor can be a:

• Spouse/significant other
• In-law
• Close friend
• Adoptive parent
• Adopted child (over the age of 18)
• Co-worker

Altruistic liver donors: Donors do not have any personal connection to the recipient. They are often influenced by personal experiences or motivated by a desire to help others through a selfless act of donating a portion of their liver to a person in need. 

Paired Exchange:  When a potential donor is not a match for the intended recipient, the donor will donate a portion of their liver to another recipient in exchange for a compatible liver for their intended recipient. This is an option for living donors who want to donate, but may not be a good match due to non-compatible blood type, antibody levels, or other medical reasons.  The transplant center may arrange an exchange with another pair within the same center or another transplant center. The living donor team can discuss all options available if you are not able to donate to your intended recipient. 

Contact the UC Health Liver Transplant team to explore becoming a living liver donor: Call 513-584-9999, or register at https://omnilife.health/uc-living-donor/ to start the process.

The evaluation process begins with an initial screening to determine if you are a suitable donor and ensures the donor’s safety. This process includes:

• Medical Tests: Blood tests, imaging (CT scan or MRI), and physical exams to assess liver function and evaluate overall health.
• Psychological Evaluation: A consultation with a psychologist or social worker to discuss motivations and ensure emotional readiness.
• Multidisciplinary Review: A team of specialists, including transplant surgeons, hepatologists, and nurses, will assess the donor’s eligibility.

After evaluation, if you are a suitable donor, you will meet with the transplant team, which includes:

• Transplant Surgeons: They will explain the surgical procedure and answer any questions.
• Transplant Hepatologists: Liver specialists will review your medical history and evaluation results.
• Nurses and Coordinators: They provide support and information throughout the process.If you would like to talk to someone who has been a living donor, the transplant nurse will be happy to provide you with the name of a contact person with whom you can discuss the donation process.
• Living Donor Advocate: They will guide the donor through the evaluation process, ensuring informed consent and the potential donor's rights and best interests are protected.

Before surgery, you will receive instructions on how to prepare, including:

• Dietary Guidelines: Recommendations on what to eat and drink leading up to the surgery.
• Medication Adjustments: Guidance on any medications you may need to stop or adjust.

On the day of the surgery, you will be admitted to the hospital. The procedure involves these key steps:

1. Preparation: The donor is placed under general anesthesia.
2. Liver Removal: A portion of the donor’s liver (usually 60-70%) is surgically removed.
3. Closure: The donor’s incision is closed with sutures or staples.
4. Transplantation: The donated liver segment is transported to be transplanted into the recipient, who has been prepped and ready to receive the transplant. 

Recovery typically involves:

• Hospital Stay: Donors remain in the hospital for 3-5 days post-surgery.
• Pain Management: Medications are provided to manage any discomfort.
• Follow-Up Care: Regular check-ups will monitor liver regeneration and overall health.
• Activity Levels: Most donors return to normal activities within 6-8 weeks, but complete healing may take several months.

• Life-Saving Impact: Living liver donation offers recipients a chance for survival when deceased donor organs are scarce.
• Shorter Wait Times: Living liver donations reduce or eliminate the time patients spend on waiting lists for a transplant.
• Better Outcomes: Studies indicate better long-term survival rates for recipients of living donor transplants.

• Emotional Fulfillment: Donors often report a sense of pride and satisfaction from helping someone in need.
• Health Monitoring: Donors receive regular health check-ups, which can help maintain their overall well-being.
•  Liver Regeneration: The donor’s liver typically grows back to its original size within months.

While living liver donation is generally safe, potential risks include:

• Surgical Complications: As with any surgery, there are risks such as bleeding, infection, or adverse reactions to anesthesia.
• Temporary Liver Function Issues:The remaining liver may take time to adjust to its new workload.
• Recovery Challenges: Donors may experience pain and require time off work for recovery, typically ranging from several weeks to months.

Understanding these benefits and risks can help potential donors make informed decisions about kidney donation.

The Living Liver Foundation offers comprehensive resources for liver donors, including educational materials, support groups, and advocacy programs.

UC Health has a dedicated living donor program that offers personalized support to guide potential donors through the evaluation process, surgery, and recovery. We also provide access to counseling services, ensuring donors feel supported at every step.

Most costs for the living donor are covered by the recipient’s insurance coverage. However, this may vary with individual insurance payors. If you have questions about payment, one of our financial counselors will be happy to assist you. The donor advocate will discuss your eligibility to receive funding from the National Living Donor Assistance Center (NLDAC).