What Are the Benefits of Living-Donor Liver Transplantation?
- Decreased waiting time for liver transplantation and prevention of adverse outcomes, including death while on the national deceased-donor waiting list
- Surgery can be scheduled at the optimal time for the recipient and donor
- Patients know the quality of the donor liver
- Excellent outcomes that are better than for patients who receive deceased-donor transplants
- Donors have the knowledge that they have saved the life of the recipient
What Are the Risks of Surgery for the Donor?
Surgery of any type is associated with risks. Major complications are rare with living donation, but all risks of the surgery will be discussed with the donor by the transplant surgeon during the evaluation process.
Who Pays for the Costs of Living Donation?
The liver recipient’s health insurance typically pays for the donor’s health care expenses, including doctors’ fees, hospital costs, and post-surgical follow-up visits. Costs such as lost income, travel, lodging, and other related expenses are usually not covered by insurance or the hospital.
The Evaluation Process
At UT Southwestern, the paramount goal during the evaluation process is to protect the donor’s health and well-being.
The evaluation process takes place in three stages:
Stage 1 – Screening of potential living donor candidates
- All liver transplant candidates are educated about the role of living-donor liver transplantation
- Recipients identify potential donors who contact UT Southwestern expressing an interest in being a living donor
- A Living-Donor Health History Questionnaire is completed by the potential donor
Stage 2 – Evaluation Day
- Consultation with the living-donor transplant team, including transplant surgeon, transplant hepatologist, social worker, and psychiatrist
- Meeting with independent living-donor advocate
- Blood tests/electrocardiogram (ECG), echocardiogram/liver imaging including MRI/CT scan performed
- Education session about living donor transplantation
Stage 3 – Scheduling date of surgery
- If the living donor is approved, the transplant team will work to select a suitable date for surgery
Living-Donor Liver Transplant Surgery
The operation takes between 6 and 8 hours. The recipient and donor are in two adjoining operating rooms at the same time with two separate teams of surgeons operating simultaneously. The donor is closely monitored in the surgical ICU by specialized nursing and medical staff for the first 24 hours after surgery. The following day, the donor is transferred to the transplant floor and cared for by nurses and the transplant team with expertise in looking after living donors. The total expected inpatient stay is approximately 5 days.
Following discharge from the hospital, donors recover at home. Recovery rates vary between individuals, but most return to work within eight weeks of surgery.
Donors are monitored closely in the outpatient clinic and are seen at:
- 7–14 days post-donation
- 30 days
- 90 days
- 6 months
- Annually for at least two years