Information for Living Liver Donors

The journey to living liver donation can be a long and challenging process and potential live liver donors are very carefully evaluated. All living liver donor evaluations are completed at the BIDMC Transplant Institute.

The donor evaluation is a comprehensive assessment to determine if it is safe for a presumably healthy potential living donor to undergo elective major abdominal surgery which offers them no clinical benefit. All donor decisions are made in their best interests, even if declining a donor results in the intended recipient not being able to benefit from LDLT. About 25% of those expressing an interest in living donation undergo donor surgery.

The testing to become a liver donor occurs in phases and begins with a telephone health screening conducted by the live liver donor nurse coordinator. Advancing through the donor evaluation may be dependent on acceptable results during the previous phase.

All charges for the donor evaluation are billed to the recipient's insurance.

Phase 1 Consults and Testing

• Live Liver Donor Coordinator
• Hepatologist (medical doctor who specializes in the care of patients with liver disease)
• Living Donor Social Worker
• Laboratory testing to determine if you have any obvious liver problems, unknown medical conditions, blood clotting disorders or an incompatible blood type
• A Chest X-Ray
• Liver Ultrasound
• Electrocardiogram (ECG)

Phase 2 Consults and Testing

• MRI to determine the amount of liver volume you have in various segments of your liver
• Echocardiogram to evaluate the function of your heart

Phase 3 Consults and Testing

• Hepatic Arteriogram
• Surgeon
• Independent Living Donor Advocate - this is a member of the living donor team who is responsible for advocating for your best interests as a potential living liver donor. She/he will review your understanding of living liver donation process, help you understand the benefits and risks of living liver donation, respond to any questions or concerns and ensure that you remain committed to living liver donation.

Additional testing and consults may be needed depending on your health history or interval evaluation results. Examples of additional testing/consults include:

• Liver biopsy
• Pulmonary function testing
• Meeting with transplant psychologist
• Chest CT scan
• Infectious disease consult

All information concerning the donor is kept in strict confidence and will not be given to the potential recipient or any third parties.

In the Hospital

• The average inpatient hospital stay for the donor is 5-7 days.
• You will recover on Farr 10, The Transplant Unit. The nurses and staff there will encourage you to get out of bed to walk and to exercise your lungs by coughing and breathing deeply.
• You will experience pain at your incision site; the degree of discomfort varies from one person to the next and is managed with medications.
• You may experience nausea related to the anesthesia; you will have medication available to manage this symptom.
• You will be given a shot to prevent you from having blood clots in your legs or lungs. You will be taught how to do this at home for approximately six weeks.

After Discharge

Every person recovers from surgery at a different pace but typically recovery can take from 8-12 weeks.

If you have traveled from out of town to donate, we ask that you stay locally for at least the first two weeks after surgery.

You will have regular follow up appointments at the following intervals after donation:

• 1 week 
• 2 weeks
• 4-6 weeks
• 3 months
• 6 months
• 1 year
• 2 years

Liver Donor Recovery Timeline

Here is what you can generally expect during your recovery:

• In 2-3 weeks: Your liver function will normalize. You will be allowed to drive again when you regain your physical strength and no longer require pain medications.
• By 6 to 12 weeks: Your activity level will increase and you may wish to return to work or school. Some people heal quicker than others, so this time varies greatly from donor to donor.
• In 2 to 3 months: Your liver volume will have regenerated to at least 80% its original size. Most patients report feeling “normal” and nearly all donors are back to work or school.

• Living donor transplant can help save the lives of people with end stage liver disease and increase the number of livers for people on the transplant waiting list. 
• Living liver donors can feel good knowing that they have a positive impact on another person’s life. 
• Living liver donors and transplant recipients can often schedule surgery at a time that works for both people.
• Because they are receiving a portion of a healthy donor's liver, recipients typically have improved long-term outcomes and quicker recovery times.