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The Liver Donation Evaluation Process

Clip Number: 6 of 25
Presentation: Liver Donation Evaluation
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Reviewed By: Arthur Schoenstadt, MD
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Going through the evaluation process doesn't guarantee that you will be able to donate part of your liver. Only people who meet certain requirements are able to donate. These criteria include things like being in good health, having the right blood type, and having a liver that's the right size - it has to be large enough to support both you and the recipient.
There are several steps in the evaluation process, each more involved or complex than the one before it. This is so you don't have more tests than you really need. In the first step, your healthcare provider will test your blood to make sure it is compatible with the recipient's blood type. This is because the donated liver section won't work right if the blood types aren't a good match.
If your blood type IS a good match, you can enter the second part of the evaluation process, which is a series of tests to look at your health. In this step, your provider will talk to you about your health history and do a physical examination. You will also have blood draws, urine tests, a chest x-ray, and an electrocardiogram, or EKG. An EKG measures the electrical activity of your heart to see how well it's working.
At some point, you will be tested for diseases that can be spread to other people through contact with your blood or liver, such as HIV or AIDS, hepatitis, and syphilis. Depending on where you live, if you have one or more of these diseases, your transplant center may have to report this to the state Board of Health.
The most important factor of this stage of the evaluation is your health. Liver donors need to be healthy enough to have a major surgery with as little risk as possible.
If the second part of the evaluation shows that you can be a donor, you can choose to enter the third stage of the screening. In this stage, tests are done to measure the size, blood flow, and condition of your liver. These tests include having images of your liver and its blood vessels made by:
• An ultrasound
• A CT scan
• Or an MRI.
It's important for the donated liver to work right and have a good blood supply. Both of these things influence how well the liver will work in the person receiving it.
Depending on your health, medical history, and results of your previous tests, more tests may be needed to see if you qualify to be a liver donor. Some of these can include:
• A liver biopsy, where a needle is used to remove a small sample of the liver tissue
• An angiogram, where a special dye is put in the liver's blood vessels so x-ray pictures can be taken of your liver
• And meeting with other specialists or having other tests.
Finally, all potential donors will also have a mental health evaluation to make sure they are emotionally and mentally able to deal with donation surgery.
Not every liver donor will need all of these tests. The purpose of each test is to fully evaluate the factors that will determine your risk as a donor and the health of your liver.
You can find out more about any of these potential tests by choosing from the list of options on the next screen.

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