Living Donor Liver Transplant

Living Donor Liver Transplant

At UCSF Medical Center, most transplanted organs come from deceased donors. However, we perform an increasing number of liver transplants using portions of livers donated by a living relative or friend.

Living donor liver transplants are possible because the liver has the unique ability to regenerate itself. In the procedure, the surgical team removes the diseased liver from the recipient, then transplants a portion of the donor's liver in its place. The donor's remaining portion of liver quickly grows back to its original size, within eight weeks or sooner.

Having a living donor not only reduces the waiting time until transplant, it improves 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 the donor and recipient are in nearby operating rooms and the donated liver portion is transported within minutes.

Surgeons around the world began performing living donor liver transplants using adult donors for children who needed transplants. UCSF Health surgeons have performed these transplants between adults and children since 1992.

Surgeons outside the United States, mostly in countries where organs from deceased donors are unavailable, expanded the technique to adult recipients in the mid-1990s. Since then, many centers throughout the world have begun to perform living donor liver transplants between adults. UCSF performed its first adult-to-adult living donor transplant in January 2000 and has since performed hundreds of these operations.

Donor Eligibility

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 need to be a relative of the recipient so long as you're a good match in other respects, such as blood type.

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

Donors should be:

• 18 to 65 years of age
• In good health with no major medical or psychiatric illnesses
• A nonsmoker for at least six weeks before surgery
• Off birth control pills for at least six weeks before surgery
• Able to understand and comply with instructions for surgery preparation and recovery

If live donation is a feasible option for a patient, we will perform a donor evaluation after the recipient's testing is complete. If the transplant team determines that 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.

Donor Evaluation

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

• Lab work
• CT abdomen with IV contrast
• MRI abdomen with IV contrast
• Echocardiogram
• Treadmill stress test (males over 35 years old, females over 45 years old, active smokers within five years, and patients with hyperlipidemia, diabetes or hypertension)
• Medical history and physical
• Independent living donor advocate and social worker consultation
• Psychiatric consultation (depending on medical history)

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.