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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Transplant

Living Liver Donation Frequently Asked Questions (7409)

Living Liver Donation Frequently Asked Questions (7409) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Transplant

7409

Live Liver Donor Transplant - Frequently Asked Questions

Q. What are the advantages to getting a living donor liver transplant?

A. They are:
ξ Decreased wait time. Live donor transplant allows patients to receive a transplant sooner than
waiting for a deceased donor liver
ξ Patients more likely to return to a better quality of life in less time
ξ Decreased chance of dying while waiting for an organ to become available.
ξ Planning. In a live donor transplant, the surgery date is set ahead of time. This allows everyone
time to make plans, and to schedule the surgery at a time that is more convenient for all.

Q. What are the risks for the person who gets the transplant?

A. Living donor transplant is a more complex surgery than deceased donor transplant. There are more
risks when you have a live donor liver transplant procedure, such as bile duct problems. Most of these
problems can be treated. But there is a risk that it could lead to graft loss or death.

Q. Who can be a donor?

A. The UW Transplant staff takes great care to review each person's case to learn about risk factors for
them as a potential live donor. It is the donor team’s job to take this process very seriously. Below are
some basic guidelines for who can and cannot be a donor. The donor care team makes a decision based
on each person’s individual case.
ξ A living donor can be related or un-related, and must have an established relationship with the
recipient
ξ A donor must be between 18 and 55 years of age. A donor must be old enough to provide
informed consent and young enough to have a healthy liver.
ξ The donor’s main goal should be to help the recipient.
ξ The choice to donate must be voluntary without outside pressure, coercion, or financial gain.
ξ The donor must be in excellent physical and emotional health. The donor must be free of major
health issues.
ξ The donor must have a blood type that is well-matched with the recipient’s blood type.
ξ Donors must have a body mass index (BMI) less than 35.
ξ A donor cannot have cancer.
ξ A donor cannot have any active infections.
ξ The donor must have normal or near normal liver function and have no history of any liver
disease.
ξ The donor’s liver must have a pattern of blood supply and bile duct placement that are suitable
for transplant. Each person’s anatomy is different.
ξ The donor must have family or friends who can provide support before, during, and after the
surgery.

ξ The donor must be able to plan for up to three months off from work.
ξ The donor must know and be able to state the risks of living liver donation.
ξ A donor must have a primary care doctor.
ξ A donor is strongly advised to have their own health insurance. Lack of health insurance may
exclude a person from being a donor.

Q. What is the process like to be a live donor?

A. The person willing to be a donor has a thorough medical, surgical, and psychosocial evaluation prior
to undergoing this voluntary surgery. This involves several full days of testing and meetings with
doctors, nurses, social workers, and psychologists at UW hospital. This person will have their own team
helping them through the process. After review of the testing, a decision is made by the team whether
the person is able to be a donor.

Q. What are the risks for the live liver donor?

A. While the results of adult-to-adult living donor liver transplant are very good throughout the world, it
does carry risks for the donor.
ξ Surgical risks: Although the live donor evaluation process attempts to reduce risks to the live
donor, no surgery is without any risk, and this is true for live liver donation as well. Some of the
risks include, but are not limited to:
 Injury to the bile ducts or blood vessels that remain in the liver. This can result in liver
failure and the chance of the donor needing a liver transplant.
 Reaction to the anesthesia given during the surgery.
 Stroke or heart attack.
 Blood clots in the legs or lung.
 Fluid around the lungs or collapse of a lung.
 Fluid retention.
 Mild or severe infections, such as pneumonia, urinary tract infections, or wound infections.
 Uncontrolled bleeding that results in blood transfusions.
 Another surgery.
 Bile leakage or bile duct problems.
 Injury to other organs such as the spleen, stomach, or intestine.
 Scar.
 Pain in the incision that doesn’t go away.
 Problems with wound healing.
 Hernia.
 Bowel problems, such as slow or blocked bowels.
 Depression, anxiety, or other problems with mood, particularly if the transplant recipient has
a hard time.
 Problems with getting insurance in the future
 Death – The national experience in the United States with living donor liver transplant
includes over 4600 live donor liver transplants. There have been four deaths reported in
donors in the United States over the past 15 years. This would give a death rate of less than 1
in 1000. However, higher estimates of death rates for this procedure have been discussed, as
high as 0.5%, (1 in 200).


Q. What are the costs of live donation?
A. The live donor evaluation, surgery, hospital stay, and after care must be covered by the recipient’s
insurance, not the donor’s personal insurance. Some insurance companies do not cover live donation.
However, once your insurance has given authorization, the medical and surgical costs of live liver
donation are covered for the donor—even if they are ruled out during the evaluation, or choose not to
proceed. Donors should plan on being off work for 8 to 16 weeks. Being a liver donor may affect long
term job status.
ξ There may be other expenses, including travel costs to get to Madison, or unpaid time off work.
These can be discussed with the live donor social worker to learn about any resources that may
be available.

Q. What is the surgery and recovery like for the donor?

A. Part of the donor’s liver is removed so that it can be implanted inside the person who needs the liver
transplant. The remaining portion of the liver generally grows bigger in the weeks after the surgery. Live
liver donors usually spend a day or two in the intensive care setting, and then move to the transplant
floor for a few more days. The recovery time after live liver donation varies, but typical time off work is
anywhere from 8 to16 weeks. During this time, live liver donors will need extra support at home. They
will have follow-up appointments at the transplant clinic. Overall, the recovery can last several months.
It is expected that the live liver donor will return to their normal state of health and quality of life after
the recovery phase.

















Your health care team may have given you this information as part of your care. If so, please use it and call if you have any
questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical
advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are
different, you should talk with your doctor or others on your health care team when using this information. If you have an
emergency, please call 911. Copyright © 1/2016 University of Wisconsin Hospitals and Clinics Authority. All rights reserved.
Produced by the Department of Nursing. HF#7409.