Q&A with Drs. Elizabeth Pomfret and James Burton, University of Colorado Hospital
Drs. Pomfret and Burton are both members of our Medical Advisory Committee
What is live donor liver transplantation?
Live donor liver transplantation is when a healthy person donates a portion of their liver to another person in need of a liver transplant. About 40-60% of a healthy person’s liver is removed and transplanted into an adult recipient after their original diseased liver is removed. Infants and small children require less liver volume. The portion of liver that remains in the donor and the portion that is transplanted into the recipient then regenerate over the next several months to the size that their bodies need.
Is live donor liver transplantation right for you?
With only about half of people United States donating their organs when they die, there are more people waiting for liver transplantation and organs available. Unfortunately, the results of this is many patients die on the transplant list waiting for an organ.
Live donation offers another way to perform lifesaving transplants. Choosing the option of live donation can:
Make a recipients wait for transplant much shorter.
Give the recipient the chance to receive a transplant.
Allow options on the timing of the transplant.
Allow transplantation before the recipient becomes too sick.
On average, live donor liver transplant recipients have outcomes as good as–and often better than–those of recipients of deceased donors. Also, live donor liver transplant recipients are 50% less likely to die waiting for transplant, compared to those waiting for deceased donor.
Who is a candidate to receive a live donor liver transplant?
To be a candidate for live donor liver transplant, the recipient must first be an acceptable candidate for deceased donor liver transplant. Sometimes recipients are too sick or have anatomical or medical problems that would prevent them from having a successful live donor liver transplant. Live donor surgery is best for patients who do not have a spot that high enough on the transplant list to receive a deceased donor liver but who are sick enough to need a liver transplant. Recipient should talk to their transplant team and ask if live donor liver transplantation is right for them.
What are the potential risks or complications?
Any time major surgeries are done there are risk. The risk are directly related to the amount of liver tissue that is removed from the donor. The risk of death or need for the donor to need a transplant as a result of a complication from this surgery is estimated to be 0.1% (1 in 1000) to 0.5% (1 in 200), depending on how much liver tissue was removed.
Some of the serious complications from the surgery include the risk of a bile leak, the need for a reoperation or blood transfusion, damage to a bile duct or blood vessel, infection and slow liver function during liver regeneration. More often (90% of the time) the complications are minor and can include wound infections or gastrointestinal upset (such as nausea, bloating, constipation and/or diarrhea). This will be discussed in extensive detail during the donor’s evaluation. Occasionally the donor evaluation will identify an incidental finding during the donors evaluation that will require further medical follow-up.