Becoming a Living Liver Donor
There are many more people waiting for a liver transplant than there are donors. Up to one in four patients on the liver transplant waiting list will die before a liver becomes available. You can save a life by donating part of your liver. In fact,our long term results from a living liver transplant are better than from a deceased donor transplant.
The liver is an organ that:
- makes bile
- filters toxins
- makes hormones
- and helps fight infections
The liver can get damaged for many reasons. Your liver can sometimes repair itself. If it can't, you need a liver transplant.
If you donate a piece of your liver to someone who needs it, the rest of your liver and the piece you donated will grow back quickly and work normally.
Assessment (words) – Who can be a living donor?
To be a living liver donor you must:
- be in overall good health
- have a blood type that the recipient can accept easily
- have a near normal body weight
- have a healthy liver
- be between the ages of 18 and 55 (Please contact the living liver program if you still want to donate but are not within this age range, and we will consider you on a case-by-case basis.)
You will need to:
- give your medical history and information about your lifestyle
- have your blood taken and tested
- go for imaging tests such as a chest x-ray, MRI or CT scan
Rarely you will need a liver biopsy or more tests.
It may take 2 to 6 months to finish all the routine tests. Urgent cases may take much less time.
Once your testing has been completed you'll meet with the living donor healthcare team to see if you can become a living donor. The team is made up of a nurse coordinator, surgeon, general medicine doctor, social worker, dietician, and psychologist. You may have to meet with other Specialists as well. All of these appointments will take time to organize.
It's important to be and stay healthy as you go through the donation process (called the work-up). If at any time your healthcare team feels it is unsafe for you to do the work-up, they will stop it. Don't be upset if the process is stopped.
Only a small number of people that come forward to be a living donor are accepted. You can also stop the donation process at any time if you feel it's not right for you. Talk to any member of the living donor team if you decide you no longer want to donate.
We will support your decision fully no matter what you decide. The recipient will only be told that the work-up has stopped. It's up to you if you want to share why you decided to stop.
You will be admitted to hospital on the morning of your surgery. The pre admission clinic will give you detailed instructions about how to prepare for surgery.
Once you are in the operating room, you will be given medicines to put you completely asleep. You will also have tubes placed into your body before the surgery begins:
- a breathing tube to help you breathe while you are asleep
- a central venous catheter to give you fluids and medicines
- an arterial line to check your blood pressure and get blood samples
- a nasogastric tube that goes through your nose and into your stomach to help prevent vomiting and the back-up of stomach acid into your lungs
- a catheter to drain urine from your bladder
To do the surgery, the surgeon makes a cut called an incision down the middle of your belly (called the abdomen) and across your right side (like a backwards L)
The surgeon looks at your liver to make sure it looks healthy for a transplant. If so, the surgeon will continue with your surgery. If they find something that could put you at risk, the surgery will be stopped.
Your gall bladder will be removed. Removing your gallbladder is a routine part of the surgery.
The surgeon will separate the lobes of your liver, your blood vessels and your bile ducts.
The surgery time is generally 4-6 hours; sometimes it can be longer.
The part of your liver that is removed is transplanted into the recipient as soon as possible. This is done in a separate operating room on the same day as your surgery, by a separate surgical team. Once your incision is closed, you will go to the recovery room.
Once you are awake and stable you will be taken to your bed on the unit.
There are potential risks of having liver surgery
- bleeding – You may occasionally need a blood transfusion to manage bleeding.
- blood clot in your legs or lungs – Go for walks and do light exercise each day to prevent blood clots. You will also get blood thinner medicine to help prevent a blood clot while you are in the hospital.
- injury to a bile duct – There is a small chance that you will have an injury to a bile duct. If this happens, you may need another surgery to repair it.
- needing a liver transplant – In very rare cases you may need a liver transplant if something unexpected happens during surgery. To date, this has not happened in our program.
- death – While there have been no deaths relating to living liver donation in Canada, very rarely there have been deaths in other programs. The risk of death is estimated to be 1 out of 1000 liver donation surgeries.
Some short-term health problems that can happen after surgery include:
- nausea and vomiting
- problems with your heart or a lung infection called pneumonia
- a bile leak that needs to be drained
- constipation – drink plenty of fluids and walk often to prevent constipation.
- depression, especially if the recipient doesn't do well with the donated liver
- there is a small chance that your liver will not function properly resulting in jaundice, (yellowing of the skin and eyes)
A team of healthcare specialists will care for you and keep track of your progress to help you have a fast recovery. The tubes that were put in before surgery will be taken out within the first few days after surgery.
You will have a catheter in the incision in your abdomen to give you numbing medicine to help control your pain. This is called a TAP catheter. You will also get a pump so you can give yourself pain medicine when you need it. When you are ready, your healthcare team will switch you to pain medicine that you take by mouth. Before you leave the hospital, you will get a prescription for pain medicine pills by mouth to take at home when you need it.
Most people will need to stay in the hospital for 5 to 10 days. When you leave the hospital you will need to stay in the Edmonton area for a few days.
Your recovery may take 6 to 12 weeks.
Don't lift anything heavier than 10 pounds or do activities that take a lot of energy until your healthcare team says its okay (usually 3 months after donation). Most complications happen soon after surgery, but some may happen after you leave the hospital.
Call your Living Donor Coordinator if you have any of the following signs or symptoms:
- fever over 38.5°C
- yellowing of the skin or eyes that you didn't have before you left the hospital
- shortness of breath
- pain or tenderness in your legs
- pain you can't control with your medicine
If you can't reach your coordinator, go to the nearest emergency room.
You will need to meet with your living donor healthcare team about 1 month after your surgery to see how you're doing. They will let you know if you need more follow-up appointments.
Eat a normal healthy diet. Try to eat foods that are low in fat and high in fibre such as fresh fruits and vegetables. Also eat foods that are rich in protein, such as meat and fish.
Don't drink alcohol for 12 weeks after your surgery.
Your liver will grow back to its normal size within the first one to two weeks. It will take the next few months to develop fully and function normally.
Liver donation can be a hard and long process but the rewards are great.
You can improve someone's quality of life by giving them a better future.
To contact these programs, please email