Adult Living Donor Liver Transplant -- The Donor's Perspective

It can be hard to understand the steps involved in an adult living donor liver transplant; the donor's perspective of the procedure is perhaps the simplest way to explain what happens before, during, and after the surgery. It usually takes 6 to 8 hours, and about 40 to 60 percent of the liver is removed. There are no direct medical benefits to you as a donor, and your health will not improve.

Adult Living Donor Liver Transplant -- The Donor's Perspective

Directly before the donation surgery, you will be given general anesthesia, which puts you into a deep sleep. A large incision, or cut, will then be made in your abdomen, about 2 fingerwidths below the rib cage. The length of your incision will depend on your body size, but it's usually about 15 inches for the average person.
 
Then a section of your liver (usually about 40 to 60 percent) will be removed. Your doctor will leave the other section, or "lobe," still functioning inside you. The gallbladder is usually removed and discarded. You can lead a normal life without your gallbladder.
 
Your doctor will repair the cut parts of the remaining lobe, and once satisfied that the liver is working properly, he or she will close the incision with stitches and/or surgical staples. The area is then covered with a bandage.
 
The entire adult living donor liver transplant surgery takes about 6 to 8 hours.
 

What Happens After the Procedure?

Most people stay in the hospital for 4 to 8 days after donating part of their liver, and then continue to recover at home for another 4 to 6 weeks. You will also have a few followup appointments with your healthcare team after the surgery. During the next 1 to 2 months, the liver usually returns to its normal size and function.
 

What Are the Benefits of Adult Living Donor Liver Transplant for the Donor?

It's important to know that there are no direct medical benefits to you as a liver donor. Your health will not improve. However, there are some potential indirect benefits. During the evaluation process, your healthcare team may find that you have certain medical conditions that you didn't know about before. This can be important to your future health. If a condition is discovered, your transplant team will let you and your primary care provider know. As an additional benefit, some donors also find that they have an increased self-esteem after donating part of their liver.
 
While these are possible benefits, liver donors also face risks. Some of these are minor; some can be more serious. A few of the more common risks of this surgery include:
 
  • Bile leakage
  • Pressure damage to the nerves and skin
  • A slow return to normal intestinal function
  • Hernia
  • Infection.
     
A few of the more rare, but serious, risks can include:
 
  • Liver failure, meaning that you would need a liver transplant yourself
  • Death, which happens in about 1 out of every 500 liver donation surgeries in the United States.
     
Nationwide, the overall risk for problems, both minor and major, is low and occurs in about 2 out of every 7 cases. Most of these problems are minor and get better on their own. Major problems happen in fewer than 1 out of 10 surgeries.
 
A few people who donate other organs (such as a kidney) have emotional or psychological problems after their surgery. These problems are usually only temporary. Since living donor liver transplantation is still a fairly new surgery, the exact percentage of liver donors who will have these problems is unknown.
 
You can read more detail about the surgery itself, its risks, and possible benefits by going to any of the following eMedTV articles:
 
 
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