Living Liver Donor Evaluation Process

Living Liver Donor Process

• 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 (First Day 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 pre-operation 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 (Second Day 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.

  Remainder of Stay (Third Day 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

  Care at Home 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 ten 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.

Living Liver Donor Frequently Asked Questions

• 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 ten days.