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Everything You Need to Know About Being a Living Liver Donor

Medically reviewed by Saurabh Sethi, M.D., MPH — By Eleesha Lockett, MS on September 16, 2022Share on PinterestWith over 105,000 people on the national transplant waiting list, it should be no surprise that organ donation is one of the most important medical procedures of our time. In 2021 alone, more than 11,800 people on the national transplant list were waiting specifically for a liver transplant. But what does the journey of a liver transplant involve, exactly? And what does this process look like for living liver donors who make the choice to donate a part of their liver? Here, we map out everything you need to know about the living donor liver transplant process as a potential donor.

Living liver donor guidelines

A liver transplant can be performed in one of two ways: the organ can come from a deceased donor, or it can come from a living donor. In a living donor liver transplant, the living donor gives a portion of their liver to the recipient. The partial liver can then grow back into a full liver — for both the donor and the recipient. Because donating a portion of your liver is such a huge task, not everyone qualifies to be a living liver donor. To qualify as a living liver donor, according to 2016 research, you must be:between the ages of 18 and 60able to provide full consentin good physical and mental healthcompatible in blood type with the recipientfree from any major health issues, conditions, or concerns If you qualify to be a donor and would like to move forward with the process, there’s a thorough evaluation that you’ll need to undergo first. This evaluation includes:a health-screening surveymultiple types of blood testsviral and infectious disease testingimaging tests, such as MRI and CT scansboth physical and psychiatric assessments

What disqualifies you from donating a liver

Even if you’ve made it all the way through the evaluation process, you still might not be accepted as a living donor. In fact, early research from 2013 has suggested that only around 40% of people who are interested in living liver donation are accepted. According to 2006 research, some of the most common reasons for not being accepted as a live liver donor include:underlying medical conditions, like hypertension, liver or kidney irregularities, or cancer (some of which are caught during the evaluation)underlying mental health conditions, such as depression, anxiety, or substance use disordernewly discovered concerns found during scans, like noncancerous growths or blood vessel irregularities in the livera higher level of fat in the liver (called steatosis) than previously assumed If you are approved to be a living liver donor, your doctor will likely spend some time helping you prepare for the surgery. For example, they may want you to donate blood, take prophylactic (preventive) medications, or make other lifestyle changes ahead of time to reduce the risk of complications before and after the surgery.

Did you know

When you choose to donate your liver, either the left liver lobe or the right liver lobe can be used for the transplant. Because the right liver lobe is much larger than the left lobe, most people undergo right liver lobe transplantation, according to 2007 research. Regardless of which procedure is chosen, however, the result is usually the same. Both portions of the liver will regrow to become a fully functioning liver in a few months.

What does a liver donation cost

Living donor liver transplants can be an expensive endeavor, both for the donor and the recipient. As the donor, all your expenses related to the evaluation and the surgery are generally covered by the recipient’s health insurance — and that includes both private insurance and Medicare. Covered expenses are usually limited only to the evaluation and the surgery, though, and not to any additional expenses, like child care, lodging, or lost wages. While it is illegal in the United States for someone to knowingly pay you for donating your liver, some recipients — or even national foundations — may be willing to help directly cover some of these additional costs, per 2020 research.

Side effects and risks of a liver donation

Despite the nature of liver transplantation, donating a liver is surprisingly safe for healthy people. Statistics show that the mortality rate of liver donation is as low as 0.2% and 0.5% for left and right lobe transplantation, respectively. But just because the surgery is safe for most people doesn’t mean it’s entirely free of side effects or potential risks. For example, according to 2020 research, some of the immediate postsurgery side effects might include:infection at the surgical sitebleeding from the surgical woundblood clots or pulmonary embolismchanges in intestinal movementsurinary tract infectionleakage from the bile ductpneumonia

Long-term effects of liver donation

Research has shown that most people who undergo liver donation are able to get back to their typical day-to-day life relatively soon after the surgery. In fact, one early study from 2010 found that living liver donors generally reported returning to their “baseline” quality of life in as few as 6 to 12 months after liver donation.

How effective can a liver donation be

According to the United Network for Organ Sharing (UNOS), over 6,500 living donor transplants were performed in 2021 — which is over 14% higher than the number of transplants performed in 2020. And with more than 105,000 people on the organ transplant waiting list, it’s an undeniable fact that these types of transplants — whether liver, kidney, or another organ — can save lives. Liver donation is extremely effective at prolonging someone’s life. A 2020 annual report found that overall survival rates for adults with liver transplants were over 93% at year 1, more than 81% at year 5, and almost 62% at year 10.

Getting Support

Becoming a living liver donor can be a daunting process, so it helps to have some support along the way. Whether you just want to know more about the process or are already on the way to becoming a donor, here are some organizations to check out if you’re looking for more information and support:OrganDonor.govThe American Liver FoundationThe American Transplant FoundationDonate Life America And for donors, recipients, and family members, consider checking out Penn Medicine’s Liver Transplant Support Group and UNOS’ Support Groups.

Recovery timeline after liver donation

A living liver transplant is a big procedure for anybody to go through, so it’s important to know how best to take care of yourself after your surgery. Here are a few things to keep in mind as you recover. As with any major surgical procedure, the transplant will take place in a hospital, with a skilled surgical transplant team. Once you’re out of surgery, you’ll remain in the hospital under close observation for anywhere from 5 to 7 days. During this time, your care team will help you get used to sitting up, walking, eating, and using the bathroom again, among other tasks. After you leave the hospital, you can gradually begin to resume your regular day-to-day activities — with an emphasis on gradual. For most people, this also includes being able to return to their regular work schedule after roughly 6 to 12 weeks, depending on the speed of their recovery. One of the most important parts of recovering from a liver donation is keeping in close contact with your care team. You will have to return multiple times within the first year of your surgery for follow-up visits and testing to ensure that everything is healing the way it should be.

Liver donation frequently asked questions

If you’re interested in becoming a living liver donor, you likely have a long list of questions for your doctor. Here are some of the most common ones to help get you started.

What is the age limit for a liver donation

Age is one of the major qualifications for being a live liver donor — especially in the case of older adults. If you’re interested in becoming a live donor, you must be at least 18 years old but not over 60 years old.

Does liver donation leave a scar

Liver donation is a major surgery that results in scarring for both the donor and the recipient. In the case of the recipient, living liver donation leaves behind a visible scar on the upper abdomen that is often described as being the shape of a hockey stick, per 2021 research.

How long does liver donation surgery take

According to the University Health Network (UNH), which runs one of the largest liver transplant programs in Canada, liver donation surgery can take up to 6 hours. This length can vary depending on a number of factors.

Can a family member donate a liver

Outside of anonymous living liver donors, most people who choose liver donation do so for a relative, family member, or close friend. One early study from 2007 found that being a family member was one of the most common deciding factors in liver donor acceptance.

Do you need the same blood type to donate a liver

While you don’t need to be the exact same blood type as the recipient of your liver, you will need to be compatible. Here’s what blood type compatibility looks like for liver donation, according to the UHN:Blood type O: can donate to someone with blood type O, A, B, or ABBlood type A: can donate to someone with blood type A or ABBlood type B: can donate to someone with blood type B or ABBlood type AB: can only donate to someone with blood type AB

How long does liver regeneration after donation take

In the case of the donor, the remaining portion of the liver usually regrows and regains almost full function (90%) in roughly 6 to 12 weeks. In the case of the recipient, the transplanted liver will also continue to regrow after transplantation until it has reached the correct volume, according to 2008 research.

Can you get pregnant after a liver donation

Living liver donors who wish to become pregnant after a liver donation can do so. And while some research from 2021 suggests that post-donation pregnancies may be accompanied by certain complications, like increased liver enzymes during pregnancy, more research is needed. If you’re interested in both becoming pregnant and donating a liver, talk with your doctor about the risks both may pose to your overall health.

Takeaway

Over 11,000 people are awaiting a liver transplant in 2022, both from deceased and living liver donors. While it can seem overwhelming at first to even consider donating something as important as your liver, the procedure itself is a safe and effective way to help save someone else’s life. If you or someone you love is considering becoming a living liver donor, you can learn more about registering to be an organ donor here. Last medically reviewed on September 16, 2022

How we vetted this article

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uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/The_Multi_Organ_Transplant_Program_Living_Donor_Liver_Transplant_Program.pdfOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Sep 16, 2022 By Eleesha Lockett, MS Edited By Rayne Whitington Medically Reviewed By Saurabh Sethi, MD, MPH Copy Edited By Chris Doka Share this articleMedically reviewed by Saurabh Sethi, M.D., MPH — By Eleesha Lockett, MS on September 16, 2022

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