Living-donor liver transplant surgery is not as well known as other living-donor operations, but it is gradually becoming more common. Often, it is the only option available for patients facing liver disease. Deceased-donor organs are in short supply, and the amount of time a patient will need to spend on the waiting list can be unpredictable. The good news is that living liver donation is an excellent choice in many circumstances.
Why Living Donors Can Donate Part of Their Liver
Living-donor liver transplants are possible because the liver is actually composed of four lobes — it’s not just one piece — and is capable of regeneration.
The donor’s right lobe is the one that is most often transplanted. Once it’s in place in the recipient’s abdominal cavity, the transplanted liver generates additional liver tissue sufficient for proper functioning. The donor’s liver also heals and regenerates up to 90 percent of the missing tissue. The result is not perfect: the donor and the recipient do not end up with complete livers, but they do have adequate liver function (and the knowledge that they’ve freed up a deceased-donor organ for another patient).
What Living Liver Donors Need to Know
The living donor transplant procedure is a lifesaver, but there are some considerations. The donor must be in excellent health and free from:
- Pulmonary hypertension
- Congestive heart failure
- Other chronic diseases (including fatty liver disease).
The donor’s liver also must be large enough to work properly after the right lobe is removed. The operation may take several hours, and both the donor and the recipient must remain in the ICU overnight.
Many potential donors worry about the cost of the surgeries, but the recipient’s health insurance generally covers his or her end of it along with the donor’s testing expenses. For the donor, the National Living Donor Assistance Center (www.livingdonorassistance.org) can offer help with the travel and living expenses (including lost wages and mortgage payments) often associated with donating liver tissue. Social workers can also help donors plan for covering their expenses both before and after surgery.
Understanding the MELD Score
One of the more salient benefits of living donor liver donation is that the recipient usually gains access to donated tissue relatively quickly. Priority for liver transplant is assigned based upon the recipient’s MELD (Model for End-Stage Liver Disease) score. A high MELD score indicates more severe illness and the need for an entire deceased-donor liver. Because living donation involves only part of the liver, living-donor liver transplant is most appropriate for patients whose MELD score is not high enough to require a full liver. This can usually be done in the matter of a few months since a liver is readily available for transplant.
As with any health matter, it’s better to take care of problems before they escalate — it is best to discuss living-donor liver transplant before the patient’s condition begins to decline.
To learn more about organ donation and how you can help someone in need of the gift of life, visit the UPMC Transplant Services.