UCSF Children's Hospital | Medical Services | Organ Transplants

In living donor liver transplantation, a piece of liver is removed from a living donor and transplanted into a recipient. The procedure, performed after the diseased liver has been removed, is possible because the liver regenerates or grows. The liver's unique ability to regenerate itself -- combined with technological advances -- allows more people to be donors.

Regeneration happens over a short period, possibly days to weeks and certainly within eight weeks. When surgeons remove a piece of the donor's liver, the part that remains grows back quickly to its original size.

More than a decade ago, surgeons around the world began performing living donor transplants using adult donors for children who needed transplants. Surgeons at UCSF Medical Center have performed these transplants between adults and children since 1992.

At UCSF Medical Center, the majority of organs for transplantation are obtained from people who have died and whose families have given permission for their organs to be donated. But today, an increasing number of liver transplants are performed with portions of livers donated by a living relative or friend.

Nationally, there are more than 17,500 patients on the waiting list, with more added each day. Almost 5,000 patients receive transplanted livers every year, but more than 1,700 patients die each year while on the waiting list.

Living donors not only reduce the waiting time, but they improve the chance for transplant success. Patients who receive transplants from living donors can better prepare for their surgery, knowing well in advance when the transplant will take place. Also, the liver itself is "fresher" because donor and recipient are in nearby operating rooms and the donated liver portion is transported within minutes.

Potential donors must meet certain basic requirements to be considered. First, the donor must want to make this gift. During the evaluation process, we want to make sure you are not being coerced to do this in any way. You do not have to be a relative of the recipient, as long as you are a good donor match in other respects such as blood type.

Donors, however, cannot be pregnant or overweight, although overweight candidates who lose weight may be considered.

A living donor doesn't have to be a blood relative of the liver recipient, but you must have a compatible blood type. You must be in good health and be motivated to donate for altruistic reasons. If live donation is a feasible option for a patient, a donor evaluation will be performed after the recipient's testing is completed. If, after testing the donor, the transplant team determines the donation can be performed, a surgery date is scheduled for both the donor and recipient. This process usually takes up to four to six months.

Once your blood type is confirmed, you will receive a detailed confidential questionnaire about your family medical history, lifestyle and other information. The evaluation includes a series of tests to check your blood type and overall health. Tests include:

A doctor who is not a member of the transplant team will complete your medical evaluation and serve as the "donor advocate" doctor throughout your surgery and recovery.

You will be asked to donate blood before surgery in case you need it. During the surgery, about 40 percent to 60 percent of your liver will be removed.

The liver is divided into a right lobe and a left lobe. The anatomical division between the lobes permits surgeons to divide the liver into two distinct parts that can function independently of each other. The right lobe comprises about 60 percent of the total liver volume and the left lobe comprises approximately 40 percent. When the recipient is a child, a piece of the donor's left lobe, called the left lateral segment, is removed. Surgery on the donor and the recipient take place at the same time, in separate operating rooms.

The average hospital stay for the donor after surgery is seven days. You will be given pain medication after the surgery, initially intravenously into your vein and later orally. You also will receive a pain medication prescription before you leave the hospital. Most donors experience discomfort for two to four weeks after surgery.

The liver begins to regenerate almost immediately. Most of the regeneration occurs in the first two weeks after surgery, followed by a slower phase of growth over the next year.

If you're interested in donating part of your liver to a friend or relative, please call the UCSF Liver Transplant Program at (415) 353-1888 for more information. The process is confidential. No obligation is incurred in making the call or in starting the evaluation process.