Living donor liver transplantation

USUAL QUESTIONS

What is a Living Donor Liver Transplant (LDLT)?

A part of a healthy liver from one person is put into someone whose liver is damaged by disease. It’s different from a “cadaveric” liver transplant, which uses all or part of a liver from someone who has died (Brain death). The liver is an amazing organ with immense regenerative capacity and a small slice of it can grow back – for both donor and the recipient.

What are the advantages as compared to dead donor transplantation?

If you get part of a liver from a living donor, you won’t have to wait on a dead donor (cadaveric) transplant list for an organ. That means you’ll get the transplant sooner, when you’re healthier. The earlier you have surgery, before the liver disease gets complicated, the greater chance for success of transplant intervention.

Who can be a Living Donor

You’re a good candidate to donate part of your liver if you’re a parent, spouse, sibling, or adult child of the person who needs the transplant (First degree relative). You usually need to be between 18 and 50 years of age and in good health.

Who is eligible to donate?

You’ll get tests to make sure you’re a good match and your liver is healthy. In liver transplants, only blood group matching is looked at. You need to be:

  • Between 18 to 50 years
  • In good health with no major medical or psychiatric illnesses.
  • Those with a history of long-standing diabetes, blood pressure disease, heart problems, or any major illness are not eligible to be a donor.
  • You will be checked thoroughly to see if you are healthy enough to donate.

What are the risks to the donor?

Giving away part of your liver usually is safe in expert hands; the outcome depends on the number as well as the outcomes/results of the center where you plan to do a liver donation. Needless to say, centers that have done few thousand transplants will have lesser complications.

How do you prepare for surgery?

Whether you donate a liver or receive one, you need to stop smoking a month or two before the operation. Smoking makes your operation riskier and slows your recovery. The donor also needs to stop drinking alcohol. Tell your transplant team about any medicines you take. You might have to stop taking certain drugs, especially aspirin and other medicines that thin your blood, before your surgery.

What happens during donor surgery?

You and the person you’re donating to will be in nearby operating rooms. Your surgeon will make a cut in your belly and divide your liver into two pieces. The other person will get about half. After the procedure, the surgeon will close the opening and you’ll go to a recovery ICU.

How long is the hospital stay?

After liver donation surgery, you’ll spend 7 days or longer in the hospital after your surgery. You may be in the intensive care unit (ICU) for the first few nights. Then, you’ll go to a transplant ward for the rest of your stay. The medical team will help you get out of bed and walk on the day after your surgery. You’ll start on a diet of clear fluids. After a couple of days, you should be able to eat normal food again.

What is the recovery timeline like?

For donors, it usually takes about 3 to 4 weeks. You won’t be able to work during this time. You’ll have some pain, but your doctor will give you medicine to control it. Be careful not to lift anything heavy for about the first 3 months. After you donate part of your liver, your remnant organ will start to grow right after the surgery. Within 3-6 weeks, it should almost be back to its normal size.

 

After discharge from the hospital, you’ll see your doctor for regular checkups during the first month after the operation. Then you’ll have appointments about once every 3 months, and after that once a year. Generally, donors go back to their normal activities and job by the second month or so.

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