Adult Living Donor Liver Transplant: An Overview
People with diseased livers often have to wait on a long list to receive a new one. In the past, these livers came only from deceased donors -- people who had recently passed away. However, newer surgical techniques now allow doctors to take part of a liver from a healthy person and transplant it into a sick person. This is known as adult living donor liver transplant surgery. For many people with diseased livers, a liver transplant is their last hope for survival.
It's important to remember that this is a major surgery, both for the donor and the recipient. While many liver recipients go on to have active lives after a transplant, there are no guarantees that the surgery will be successful.
What Happens to the Liver?
During adult living donor liver transplant surgery, up to 60 percent of the donor's liver may be removed. The remaining liver regrows over the next couple of months, and the donated liver regrows inside the recipient as well. Although the liver increases in size fairly quickly and appears to be working normally, we still don't know how long it takes to return to full function.
The Adult Living Donor Liver Transplant Surgery
The donor and recipient surgeries usually take place at the same time.
If something unusual is found in the recipient -- like a tumor outside of the liver -- or something happens that is likely to make the operation unsuccessful, the surgeries may be delayed or cancelled.
To begin the adult living donor liver transplant, an incision is made below the recipient's ribcage. Sometimes, this is an upside-down "T" shape.
Special instruments are used to help hold the skin and other tissues open so that the doctors can reach the liver. Special clamps pinch the veins, bile ducts, and arteries of the liver to stop the flow of blood and bile. The vessels and bile ducts are then cut, and the diseased liver is removed.
The new liver, which has been waiting on ice, is placed in the same position as the diseased liver. Stitches are used to first connect the veins and then the major arteries. After the liver is correctly attached, the clamps that are pinching the blood vessels closed are removed, allowing blood to flow again. The bile duct is then attached. The doctor will then watch to make sure the new liver is working properly and that there isn't any unexpected bleeding.
Once the lobe is functioning well, the instruments are removed and the doctor uses stitches or surgical staples to close the incision. The staples are left in place for about 2 to 3 weeks and are covered by a bandage, which will remain in place for a few days.
While each transplant is different, patients usually spend about 8 to 10 hours in the operating room. The surgery itself usually lasts about 5 to 6 hours.
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