Liver transplant from a living donor
In a liver transplant from a living person, a healthy person donates part of his liver to a sick person. The donated liver will grow in the recipient over a period of weeks to months. The rest of the liver also grows in the donor and returns to its previous size. The amazing power of the liver in its reconstruction is the basis of liver transplantation from the living person. The donor can be a family member such as the recipient’s parents, sister, brother or spouse.
What are the benefits of liver transplantation from a living person?
The waiting list of patients who need a liver transplant is increasing every day. Unfortunately, some of these patients die due to the lack of a suitable liver for transplantation.
By transplanting a liver from a living person, the person can be transplanted earlier and before the exacerbation of his liver disease. Sometimes the patient is so bad because of an exacerbation of liver disease that a transplant is not possible. Transplantation from a living person allows the patient to be transplanted in a more appropriate setting. Because the transplant time is pre-determined and the quality of the liver is good, the chances of success are high. In liver transplantation, the operation is semi-emergency and the quality of the liver is not as good as the living liver. The liver donor is carefully evaluated to make sure he or she is healthy. Another point is that in a liver transplant from a living person, the time when the liver is out of the body is very short, unlike a transplant from a corpse. All of these conditions contribute to the high success rate of liver transplantation from a living person.
Who can donate liver?
The donor is carefully evaluated medically to ensure his or her full health. The safety and health of the donor is paramount. The donor should also be psychologically evaluated to ensure that he or she is aware of the potential risks of liver donation and that there is no compulsion to donate. The donor must do this voluntarily, fully aware of the potential risks. Numerous tests will be performed on the donor.
The donor must
1- Must be at least 18 years old and at most 55 years old
2- Be in perfect physical and mental health
3- Has quit smoking at least 6 weeks before donating
4- In terms of blood group, match the recipient
5. Be emotionally connected to the recipient
6- In terms of body size, it should be compatible with the recipient
What are the risks of donating a portion of the liver?
After donating a part of the liver, in most cases, the person recovers completely and returns to the pre-donated condition within a few weeks. But it should be noted that this is a major surgery that can have risks. These risks may occur during or after surgery. Some of these risks include bleeding, bile leakage, liver damage, risk of anesthesia, infection or blood clots in the leg.
Fortunately, many of these problems are treatable. The risk of death after donating a portion of the liver is one in 500 people. Sometimes the problems of this operation manifest themselves months or years later, such as abdominal pain or hernia related to surgery that can be treated with surgery.
Assessment of the donor
The purpose of evaluating a donor is twofold:
1- Achieving physical and mental health of the donor; The donor should not have any underlying disease such as diabetes or heart disease.
2- The donor’s liver should be healthy and proportionate to the recipient
Numerous tests are performed on the donor. The recipient and the donor must be of the same blood type. The donor’s liver, kidney, heart and lung function should be normal. The donor must be free of infections such as hepatitis. The donor must have a normal medical examination. The liver and its components are imaged with a CT scan or X-ray. Chest and ECG scans are taken to make sure the donor’s heart is working properly. Sometimes the liver of the donor is also sampled. The assessor sometimes takes 2 to 4 weeks, but in emergencies it can be done within 48 hours. The donor can announce his / her cancellation during all these evaluations.
During liver surgery, the donor is divided into two parts. One part of his body is then removed and transferred to another operating room for transplantation. The rest of the liver returns to normal in 6 to 8 weeks.
Duration of hospitalization
The donor will usually be in the hospital for 4 to 7 days and will be admitted to the intensive care unit for one or two days. He is then transferred to the surgical ward. Gradually the patient begins to walk and eat. During all this time, the surgical team closely monitors the donor and the necessary examinations and tests are performed to begin treatment immediately in case of any complications.
The patient is discharged from the hospital after initial recovery. The recovery period usually lasts 4 to 6 weeks. During this time, the donor will be examined and tested by a surgical team. Usually the donor can return to work after 8 to 10 weeks.
Dr. Reza Saidi Firoozabadi – Transplant surgeon