For some patients needing a liver transplant, receiving a part of a liver from a living donor is an ideal option. At Ohio State’s Wexner Medical Center, our experts perform approximately 75 liver transplants each year.

What is living liver donation?

Living liver donation occurs when a healthy person donates a portion of their liver to a transplant recipient who is suffering from end-stage liver disease. During the transplant procedure, the recipient’s diseased liver is removed and replaced with a portion of the healthy donor’s liver. The recipient and donor surgeries are carried out at the same time in different operating rooms. Since a healthy person’s liver can grow back, living liver donation is a generous decision some people are willing to make. 

Why donate?

Patients with end-stage liver disease have two options for treatment: a liver transplant from a deceased donor or a liver transplant from a living donor.

Unfortunately, the demand for organs for transplantation far exceeds the number available, and demand is steadily increasing. United Network for Organ Sharing (UNOS), the organization responsible for allocating deceased donor organs for transplant, reports that there are more than 14,000 candidates waiting for a liver transplant. In 2016, only 8,100 livers were donated from deceased donors.

For some patients needing a liver transplant, receiving a part of a liver from a living donor is an ideal option. The wait time for a liver from a deceased donor can be many months to years, depending on the patient’s ranking on the wait list. At any given time, about 70 patients in Ohio State’s transplant program are awaiting a liver transplant – many whose lives could be changed by a living donor. Patients who receive a living donor liver transplant greatly reduce their wait time for transplantation and have more control over when the operation occurs.

Because of the requirements for living liver donors at Ohio State, only select patients will be able to proceed with a living liver donor transplant. Often individuals interested in donating are family members, but a growing number are friends or co-workers. 

 

Candidates

Candidates For Donation

Candidates For Donation

Your decision to become a living donor should be voluntary and free from internal or family pressure. 

To qualify, living liver donors must be: 

  • In very good health with no chronic or serious medical conditions
  • Between the ages of 21 – 55 years old
  • Able to understand the risks and benefits and provide consent

Reasons you may not donate:

  • Active infectious diseases such as hepatitis, HIV, tuberculosis
  • Ongoing medical issues such as uncontrolled high blood pressure, diabetes and heart disease
  • History of cancer
  • Active drug abuse
  • Obesity

Living donor candidates must take a blood test to determine blood type compatibility with the recipient. It is important to note that if a donor’s blood type is not compatible with the recipient’s, they will not be eligible to donate.

The decision to become a living donor is a voluntary one, and the donor may change his or her mind at any time during the process. The donor’s decision and reasons are kept confidential.

Donor Assessment Form

Type directly into the form, then print and mail or fax to:

The Ohio State University Wexner Medical Center
Comprehensive Transplant Center

Pre-Transplant Office
300 W. 10th Ave., 11th Floor
Columbus, OH 43210
Fax: 614-293-6710
Phone: 800-293-8965

Evaluation Process

Evaluation Process

Evaluation Process

The donor undergoes a medical history review and a complete physical examination. A psychological evaluation may be used to provide information, emotional support and assess motivation.

All prospective living donors meet with our Living Donor Advocate to discuss the candidate’s decision to become a donor. The Living Donor Advocate provides unbiased, confidential support, discusses your willingness to donate and assesses your understanding of informed consent.

Here’s what you can expect during your evaluation process:

  • You will need to provide a copy of your blood type or have blood drawn to confirm blood type (the Pre-Transplant Office will provide an order for the blood draw)
  • Women donors will need to provide a copy of their last Pap test result, breast exam and mammogram report. A Release of Information form is included in this packet. Please sign the form and forward it to your doctor’s office. If your Pap test or mammogram is more than a year old, you should schedule an appointment for new exams
  • Chest X-ray and EKG (tests to determine heart and lung health)
  • Radiology imaging to evaluate and map the liver
  • A full day at the Comprehensive Transplant Center for education, meeting with the transplant coordinator, a psychosocial evaluation, surgical and medical evaluations and completion of tests
  • Any additional testing as needed
  • Final pre-donation evaluation studies (completed 10 to 14 days before surgery)

Donation Process

Donation Process

Donation Process

All donation and transplant surgeries are done at Ohio State’s Wexner Medical Center by our transplant team. If our transplant team clears you as a donor and your recipient has been identified, the surgery will be scheduled within a few weeks.

Before Donation Surgery

Week Before Surgery

 

About 10 to 14 days before the surgery date, you and your recipient will have blood drawn for a final testing, as well as HIV and hepatitis testing.

Donation Surgery

Surgery Day – Day One in the Hospital

The day of your donation surgery you will be asked to check into the hospital, usually in the early morning.

When you arrive at the hospital, you will be admitted into the hospital and taken to the preoperation area. Once you are comfortable, the doctors and nurses will conduct a final examination. You can expect to have blood drawn and an IV placed in your arm. These final health checks help our transplant staff to know that you are in excellent health for donation. You will meet your surgeon prior to transfer to the operating room. This is also a good time for you to ask any last minute questions and to openly talk about any concerns you may have before surgery.

The donation surgery usually takes four to six hours and is done under general anesthesia. About 55 to 70 percent of your liver will be removed for donation. Your remaining liver will enlarge enough to meet your body’s needs and will grow back (regenerate) to 85 to 90 percent of its original size within two months after surgery. Your gallbladder will also be removed during the surgery.

At the same time your surgeon is removing a portion of your liver, your recipient’s surgeon will be removing their liver. Then a piece of your liver will be surgically implanted into your recipient.

After surgery you will be taken to the surgical recovery room where you can expect to stay for one to two hours. When you wake up, you will have a large incision, approximately eight inches, on your abdomen. To help manage your pain, you will have a self-controlled pain pump.

After your time in the recovery room, you will be taken to the surgical intensive care unit to be monitored closely to ensure you are recovering well, have limited nausea, are able to eat, use the bathroom and pass gas, and are free from infection. Ask us for help when you want to get out of bed, as the surgery and medicines you are given can make you feel less than steady on your feet.

After Donation Surgery

Day After Surgery – Day Two in the Hospital

The day after surgery, patients are generally taken back to a private room on the transplant unit where family and friends are welcome to visit. The day after surgery, we will encourage you to get out of bed and walk with support around the hospital unit. You will also be asked to practice your coughing and deep breathing to protect your lungs. The road to recovery should be relatively quick, and you will be given pain medicine as needed to relieve any discomfort.

Day Three in the Hospital until Discharge

Most donors are able to go home five to seven days after surgery. You can expect to have some soreness and discomfort. However, you will not be able to leave the hospital until we are sure it is safe for you to continue your recovery in the comfort of your own home. In some cases, if you live more than two hours from the medical center, you may be required to stay in the area for up to two weeks after your surgery.

It is important to remember that living liver donation is a major surgery and you will need help while you recover at home. Please talk with your support person about your needs. If you have any questions, contact your living donor nurse coordinator at 800-293-8965.

Care After Donation

Home Care After Surgery

Every person reacts differently to surgery, and while some may be up and about the following week, it may take some a few additional weeks to return to normal routines. Expect to restart all normal activities within eight weeks after surgery. Please do not lift objects over 10 pounds for at least eight weeks after surgery to protect your health and prevent wound problems.

During your recovery at home, we encourage you to contact our transplant team if you have questions or concerns about your progress.

After donation surgery, your continued good health is our main concern. It is required that you schedule and keep the follow-up appointments with Ohio State’s Comprehensive Transplant Center.

Appointments after surgery will need to be scheduled for one week, three weeks, six weeks, three months, one year and two years post-surgery.

After two years, we encourage you to visit your primary care physician for annual checkups and liver tests.

Frequently Asked Questions

Fequently Asked Questions

Fequently Asked Questions

Are living donor liver transplants common?

Living liver donors are common, particularly in Canada and Asia. At The Ohio State University Wexner Medical Center, we are among a few centers in the United States that accept living liver donors.

Do living donor transplants offer any advantages over deceased donor transplants?

Both living liver and deceased donor liver transplants have about the same first-year success rate of 92 percent. However, there are several benefits to having a living donor:

  • Receiving an organ from a living donor keeps a patient from having a long wait for a deceased donor liver.
  • Preservation time and organ transportation are not factors in living donation. Donor and patient operating rooms are adjacent to each other, and the transplanted liver is working in the recipient soon after it is removed from the donor and implanted.
  • Living donation surgeries can be scheduled in advance, which allows procedures to be performed under the best circumstances for the patient and donor.
  • The entire health history of a living donor is known and verifiable.

Are living donor liver transplants common?

Living liver donors are common, particularly in Canada and Asia. At The Ohio State University Wexner Medical Center, we are among a few centers in the United States that accept living liver donors.

Who can be a living liver donor?

To be a donor, you must be in good general health. You must be free from diabetes, cancer, HIV/AIDS, hepatitis, kidney disease and heart disease. Gender and race do not matter. Individuals considered for living donation are typically between the ages of 21 and 55. A matching blood type is a requirement for living liver donation.

What testing will I have to complete?

If you decide to become a donor, the next step will be to confirm your blood type. Once received, we will proceed with any other preliminary tests that need to be completed prior to scheduling your full evaluation.

Your evaluation will include laboratory tests, chest X-ray, EKG, radiology/imaging of the liver and any other testing deemed necessary by our transplant team. Once your evaluation has been reviewed, you will be scheduled for further tests of your liver. If all testing is found to be acceptable, the transplant surgery will then be scheduled.

Are there medications I should be careful about using after donating part of my liver?

You should always check with your doctor before taking medication, including over-the-counter medicine like Tylenol (acetaminophen).

Who pays for the donation surgery?

Your evaluation and surgery are paid for by the recipient’s medical insurance. However, some things to consider that are not covered are travel and lodging expenses (if any) and lost wages from work if you do not have ill or vacation time. Some donors may qualify for assistance with travel and lodging. The usual recovery time for a donor is eight weeks.

How long will I be in the hospital?

Generally, donors are in the hospital for five to seven days. Recipients are usually in the hospital for seven to 10 days.

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