Have you ever thought that you could save someone else’s life with just one organ in your body? And that too without causing any long-term harm to yourself? The liver is one such amazing organ with a unique ability. The liver has the amazing power to regenerate itself, meaning that even a small piece can grow back to its full size. This is why a healthy person can donate part of their liver to someone whose liver is failing. The amazing thing is that after you donate, both your liver and the transplanted part of the liver grow into two complete, healthy livers within a few months.
What is living donor liver donation?
Organ transplants are usually done by people who have died. But the liver is a very special organ. As we mentioned earlier, the liver is the only organ that can regenerate itself . Therefore, a healthy, living person can voluntarily donate part of their liver to someone in need.
Simply put, a living liver transplant is two surgeries that happen at the same time. One for the person who gives the liver (the donor), and one for the person who receives the liver (the recipient). If you donate your liver, a surgeon removes a portion of your liver (usually a lobe). In a small child, it is even smaller. Once removed, that portion is transplanted into the other person’s body. After this surgery is successful, both the remaining part of your liver and the part of the liver that is transplanted into the other person’s body grow back to full size within a few months.
Can I also donate part of my liver?
Yes, if you and your liver are both in good health, you can become a living liver donor and save someone's life. However, it may not always be possible to donate a liver to someone you know. This is because your blood type and liver size must match the person's.
But imagine that your blood type is not compatible. Even then, there are ways to help you. You can donate your liver to a stranger. That will reduce the number of people on the waiting list. Therefore, the chances of receiving a liver from another donor who is a match for the person you were thinking of helping increase.
What are the basic qualifications required to donate a liver?
When you volunteer to donate your liver, doctors will put you through a screening process to make sure you are completely fit for the procedure and that it is safe for you to undergo. There are some basic requirements for this.
| Eligibility | Description |
|---|---|
| Age | You must be between 18 and 60 years old. People younger or older than that will not be selected for this. |
| Drug/alcohol use | You cannot be addicted to alcohol or drugs, because they directly affect the health of the liver. |
| Good physical health | You need to be in good physical health. Some medical conditions can make this type of surgery risky. Therefore, blood tests and heart tests are done to see if you are suitable for surgery. |
| A healthy liver | Your liver needs to be healthy. Sometimes, liver disease can be present without symptoms. Therefore, special tests are performed to ensure that your liver is in a healthy state for donation. |
| Good mental health | You must be in good mental health. You must fully understand the risks of this surgery and the sacrifices you will have to make. You cannot be forced to do this. |
| Lack of financial benefits | It is illegal to accept money or other gifts in exchange for donating an organ. The medical team needs to be sure that you are doing this 100% voluntarily and not expecting any profit. |
How does the process of becoming a contributor happen?
To start this process, you can contact a transplant hospital in your area. A coordinator will talk to you, get some basic information, and answer your questions. If they think you're a good candidate, they'll schedule a date for you to come to the hospital for further testing.
At the hospital, you will have to undergo various medical tests and see various specialists. For example:
- Anesthesiologist
- A doctor who specializes in liver diseases (Hepatologist)
- A psychiatrist or psychologist
- Social worker
- Transplant surgeon
After all these tests and discussions are complete, two independent teams will review your request. The first team will look at your safety . If they approve you, they will send the recommendation to the liver transplant selection committee. That committee will make the final decision about whether you are a good candidate for a liver transplant and who will receive your liver.
Who will receive the liver part I donate?
You can donate your liver to someone you know, for example, a family member or friend. This is called "Directed Donation" . But for this to happen, your blood type and liver size must match.
Imagine you're not a match. In that case, you can go for a "Paired Exchange" method. That means, you, the person who needs your liver, are paired with another donor and patient who are not a match, and the two donors are exchanged. That means you give your liver to the other patient, and the other donor gives your liver to your patient.
Additionally, you can donate your liver to a complete stranger. This is called a "Non-directed Donation." Once you are approved as a donor, the hospital will select a suitable donor from the waiting list. You can do this without revealing your identity. Or, if both of you are willing, there is the option to meet at a later date.
How do you prepare before surgery?
Once you and your liver recipient have been selected, the transplant team will talk to you both and set the same date for both surgeries. Once the date is set, you can prepare as needed.
- You will have to stay in the hospital for about a week after the surgery.
- After returning home, you will have to rest for about six weeks .
- So you need to plan ahead, such as taking time off from work and finding someone to take care of your children.
In addition, you will also need to do these things:
- Follow your doctor's instructions regarding food, drink, and medications before surgery.
- To further examine the condition of the liver, perform tests such as a `CT scan` or `MRI`.
- Sign the documents confirming your willingness to become a living liver donor.
Meanwhile, the surgical team takes three-dimensional (3D) images of your liver and carefully plans what part to remove and how best to perform the surgery.
What happens during the surgery?
You and the recipient of the liver (whether you know each other or not) will undergo surgery at the same time. While one surgical team removes part of your liver, another team will remove the other person's dysfunctional liver and prepare your liver for transplantation.
Your surgery will take about 4-6 hours. You will be under general anesthesia throughout the entire procedure, so you will not feel anything or be conscious.
The surgery can be done in two main ways:
1. Laparoscopic surgery: This involves making a few very small incisions in your abdomen and performing the surgery with the help of a camera. This method has a shorter recovery time and is less painful.
2. Open abdominal surgery: This surgery is performed by making a long incision in the abdomen when laparoscopy is not possible.
The doctor carefully removes the liver section that has been previously determined, separated from the blood vessels and bile ducts. Once it is removed, the transplant team takes it to the other patient and begins the process of connecting it to his blood vessels and bile ducts. Meanwhile, your doctor closes your incisions and completes the surgery.
What are the benefits of this kind of donation?
There are a large number of people waiting for a liver transplant. Some are hospitalized with sudden liver failure. Others are suffering from long-term liver disease. For all of them, time is precious.
While waiting for a liver from a deceased donor, some patients may become too ill to undergo surgery. Some may even die in the meantime. If there is a living donor, there is no need to wait on that waiting list. The surgery can be scheduled quickly.
Benefits:
- For the patient: No time wasted on the waiting list, increased success of the surgery due to a healthy liver, and a longer life.
- For the donor (you): You get the self-satisfaction and mental happiness of saving another person's life. Many people who have made such a donation say that they have gained a lot of self-esteem. They also say that if they had to make a decision again, they would make the same decision.
What are the risks and disadvantages of the surgery?
As with any surgery, there are some risks involved. Your doctor will explain these to you clearly.
| Risk type | Possible complications |
|---|---|
| Common risks of any surgery | Bleeding, blood clots, infections, nerve damage, lung infection (pneumonia). |
| Risks specific to liver surgery | Abdominal adhesions, damage to bile ducts, and incisional hernia. |
| Very rare but serious risks | Liver failure or death. According to reports, there is a risk of death for one in 500 donors (0.2%). |
| Psychological and practical disadvantages | Anxiety about the outcome of the surgery, pain after the surgery, inability to go to work during the recovery period, fear that the transplanted liver will fail. |
How many times can I donate my liver?
A living liver donation is a once-in-a-lifetime experience. Although your liver can regrow, this surgery is a huge strain on the liver. After one transplant, the liver can heal and function well for you. However, doing the same surgery a second time may not be enough for the liver, and it puts your life at great risk. Therefore, transplant teams never recommend a second donation.
How is the recovery time after surgery?
After surgery, your life will gradually return to normal.
- You will be in the hospital for the first week . This is the hardest part of your recovery. You will be given painkillers and saline, and you will be given tubes to help you walk and eat.
- You will be able to drive again in 2-3 weeks .
- Cuts heal well within 2-6 weeks .
- After 6-8 weeks, you can return to normal activities.
- Within 2-3 months, your liver will have grown back to its full size.
- You will need to go for check-ups with your surgeon throughout the next year .
Donating your liver is one of the biggest and most important decisions you will ever make. Don't make this decision in a hurry. Study all the information you receive carefully, think about all the feelings you have in your heart. Get a complete understanding of the procedure, the risks, the recovery time, and the possible results. Talk to your doctor about any questions, any fears, without hesitation. Remember, the medical team is always on your side, for your safety. They will respect any decision you make.
Take-Home Message
- The liver is a special organ that can regenerate itself, so a healthy person can donate part of their liver while they are still alive.
- To donate your liver, you must be between the ages of 18-60, in good health and in good health.
- This is a once-in-a-lifetime procedure. Your liver will grow back to full size within 2-3 months of the surgery.
- Like any surgery, there are risks involved, but there is also the immense psychological satisfaction of saving someone's life.
- This is not a decision you should make alone. You should discuss it thoroughly with your family, and especially your doctor, and consider all aspects before making the final decision.
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