Living Liver Donor Program

Overview of Loyola's Living Liver Donor Program

More than 17,000 people in the United States are currently on the waiting list for a liver transplant, according to the American Liver Foundation. While the wait time for a deceased-donor transplant can last several years, living liver donation can dramatically reduce wait times and lead to better outcomes.

In general, living-donor transplants have several advantages over deceased-donor liver transplants:

• As opposed to deceased-donor livers, living-donor livers are available sooner, which can limit complications.
• Liver donors and recipients have more flexibility in scheduling their surgeries.
• Living-donor livers often start to function immediately after transplant surgery.
• Living-donor organs often come from a relative and may be a closer match.
• The donated liver spends less time outside of the body, which improves its viability.

If you have made the decision to become a living donor, you likely have seen a loved one go through much suffering because of a serious condition. Your partial liver donation may be life-saving for the patient with end-stage liver disease.

Why Choose the Living Liver Donor Program at Loyola?

As a world-class academic medical center, Loyola’s doctors perform and teach the latest surgical treatments.  Our board-certified transplant surgeons are widely regarded and highly skilled in both traditional and minimally invasive surgery, which is often used for living donors as it leads to a quicker recovery and less pain.

Loyola’s infectious disease team works closely with donors and recipients to ensure that the transferred tissue is as healthy as possible. Our skilled and compassionate nurse coordinators work closely with living donors, providing support and answering your questions—not only before surgery, but afterward as well.

Comprehensive Evaluation and Testing for Living Liver Donors

The liver plays a key role in all metabolic processes in the body, producing proteins that are central to blood clotting, acting as a filter for the blood and removing toxins and damaged blood cells. When part of the liver is removed, it soon starts to regenerate itself.

Weighing the possibility of donating part of your liver is a noble endeavor, and we want to be sure that you are truly ready to donate. Discuss what you are feeling with your care team, family, friends, counselor or clergy.

There are various requirements to become a living liver donor, starting with a questionnaire about your health. If there are no conditions that would prevent you from safely donating, you will have the option to move forward with initial blood tests.

If you are found to be a possible candidate for donation, you will proceed to a comprehensive medical evaluation. Your doctor will take a detailed personal and medical history and conduct a physical exam. You will be instructed on the transplant process and will undergo testing, which may include:

• Antibody screening
• Arteriogram
• Blood tests for transmissible diseases
• Blood type test
• Cancer screenings
• Chest X-ray
• Cross-matching blood test
• CT scan (computed tomography)
• Electrocardiogram
• MRI (magnetic resonance imaging)
• Psychosocial evaluation
• Tissue typing
• Urinalysis

As part of your evaluation, you will meet with a psychologist for an examination to ensure that you are completely prepared for making such an important decision. There are several factors you should consider prior to making a partial liver donation, such as how this will this affect your:

• Current and future health
• Emotional health
• Family
• Finances
• Life insurance status
• Physical health

You will also meet with one of Loyola’s financial coordinators. The donor normally is not responsible for any test or surgery costs. Usually the recipient’s insurance company pays for the labs, evaluations, donor surgery, post-surgery care and clinical visits. These details will be confirmed during the appointment with your financial coordinator. Patients are responsible for their own transportation, lodging and any lost wages from missed days at work. However, your living donor advocate (LDA) can help determine whether you are eligible for financial assistance.

It is important to know that you have the right to delay or stop the process at any time. Your care team is completely separate from the recipient’s team. Nothing you discuss with your living donor advocate (LDA) or anything related to your medical condition is ever discussed with the recipient’s team. You are free to change your mind about donation at any time. The only two categories for a living donor are eligible or ineligible. You can tell your living donor advocate in complete confidence that you no longer want to donate; and the only thing ever told to the recipient and the recipient’s team is that you are not eligible to donate.

What to Expect with Living Liver Donation

Liver donation generally does not compromise the donor’s life expectancy, lifestyle or increase health risks. Donors will have Loyola’s extensive network of primary care and specialty care specialists at their disposal, making it more convenient to receive care before and after donation surgery.

Once you have been approved as a donor, your care team will work with you and your partial liver recipient to arrange the surgeries. This is usually scheduled four to six weeks in advance. Your surgery will immediately precede the recipient’s surgery.

Most living donors undergo laparoscopic surgery, which may take up to three hours. Loyola’s surgeons are highly experienced in minimally invasive surgery, which often is the approach used for living-donor surgery. The benefits of minimally invasive surgery include:

• Less pain
• Less scarring
• Quicker return to normal activities
• Reduced bleeding
• Shorter hospital stay
• Smaller incisions

There is also a small chance that, for medical reasons, your surgeon will decide to use the traditional surgical approach.

In the operating room, you will receive general anesthesia and be set up for an IV. You will be put on a Foley catheter to manage urine production during surgery. During your minimally invasive surgery, your doctor will make four very small abdominal incisions to operate thin tools and a camera. In the recovery room, your nurses will give you pain medication to ease any discomfort you may experience.

You will be closely monitored for the first 24 hours and will start to feel better within a day. You will be asked to start walking and try some deep breathing exercises to prevent lung complications. Most donors are released from the hospital after about seven days. If you are from out of town, your doctor likely will ask that you stay in the area for two weeks in case of complications.

You will be instructed not to lift anything more than 15 pounds for the first four weeks, and nothing heavier than 30 pounds for another 12 weeks. You should walk every day and stay active. If you develop a fever or wound drainage, call your nurse coordinator right away.

Your Loyola healthcare team will arrange your follow-up visits with your doctor. You should be able to drive in two weeks and return to normal activities within six weeks. You may feel some fatigue in the first six months. You will be provided with two years of follow-up care after your donor surgery.

What are the Risks with Living Liver Donation?

Living donation does involve surgery, and with any surgery there are risks. In the case of liver surgery, this may include:

Your Loyola transplant team will guide you through the decision to donate, as well as the evaluation, surgery and recovery processes. Your clinicians will help you weigh the risks of surgery to determine if you can safely donate.