FAQ for Donors
Since an individual has just one liver, how can a living person donate the organ?
Only a portion of the liver, not the whole organ, is removed for transplantation. The removed portion is replaced by new, fully-functioning liver tissue within six to eight weeks. The feasibility of living donation was first demonstrated in 1989 with successful donation of a portion of the liver from an adult parent to a child. In the national pediatric experience, about 90% of children who receive a liver from a living donor have a functioning organ one year after the surgery. Donors experience very few complications. The transplant team at Lucile Packard Children's Hospital (LPCH) has been performing living-donor transplants since 1995 with excellent results and no complications among donors.
Who can donate a liver?
A suitable donor is an individual who is in good physical and mental health, older than age 18 and younger than 55, and free from:
- HIV infection
- Chronic viral hepatitis
- Active alcoholism or heavy alcohol use
- Psychiatric illness under treatment
- History of malignancy
- Heart and lung disease requiring medications
- Diabetes mellitus of greater than seven years’ duration
- Any other serious chronic medical illness
Other factors are also important in selecting a donor:
- The donor should be a relative (close or distant) or emotionally connected to the recipient; in special circumstances, the donor can be unrelated (Good Samaritan donor).
- The donor must be mentally competent and freely willing to donate.
- Potential donors who are believed or known to be coerced must be excluded.
- No financial gain can arise from the donation. It is against the law to sell organs.
- The decision to be a donor should be made after carefully considering and understanding the procedure and accepting its risks and complications.
- The donor’s blood type must be the same as, or compatible with, the recipient’s.
- The donor liver portion must be relatively close in size to the recipient’s liver.
- Donors need to be willing and able to comply with follow-up.
What evaluations does a living-donor candidate have to undergo before donation?
The donor candidate will be asked to complete a questionnaire that includes attaching a copy of his or her blood type (to confirm whether the blood type is identical or compatible with the recipient). If the ABO blood type is appropriate, if the candidate’s height and weight compared to the recipient’s are acceptable, and if the details on the questionnaire indicate suitability, the candidate will have additional laboratory studies, including a complete blood count, liver panel, and blood tests for hepatitis B and C.
If the laboratory results confirm that the candidate is suitable as a donor, a chest x-ray and electrocardiogram (EKG) are done to make sure that he or she can safely receive anesthesia.
If the blood work, EKG, and x-ray are within normal limits, the candidate is seen by an adult hepatologist (liver specialist), who performs a complete physical exam. A volumetric CT scan calculates the volume of the liver to determine whether the portion being donated will fit the recipient. The social worker then does a comprehensive psychosocial evaluation to make sure that the candidate understands the risks of the procedure, is donating from his or her own free will, and has adequate support to be cared for after surgery.
After the tests and consultations are completed, a committee of transplant team members discusses the medical and social details of the evaluation and decides on the suitability of the candidate. One of the team members, usually the transplant coordinator, communicates the decision to the candidate. If the candidate is not selected as a donor, he or she can contact the physician team members for an explanation. Of course, all information concerning the donor is kept in strict confidence.
What kind of a postoperative period can the donor expect?
The donor usually spends five to seven days in the hospital. Most patients are up and out of bed (with assistance) by the second or third postoperative day. The donor usually needs to stay off work and suspend usual home activities for a month full-time and two to four weeks part-time, depending upon rapidity of recovery.