Living donor transplants at the Transplant Center have some of the highest success rates in the nation. Living donor liver transplantation provides patients with another option for transplant and has several advantages over a transplant from a deceased donor – the most important being a shorter waiting time for an organ.
At University of Minnesota Medical Center and University of Minnesota Masonic Children's Hospital, we have performed more living-donor transplants than any other program in the world. We developed the living donor program in the late 1990s to address the growing shortage of livers available from deceased donors. Today, we offer living-donor transplant as an option to the majority of patients who are referred to us for liver transplant.
What are the advantages of a living donor transplant?
Shorter waiting time
Approximately 18,000 people are currently on the waiting list for a liver transplant in the United States. (See the United Network for Organ Sharing Web site for the latest statistics.)
Every year nearly 9,000 new cases are added to the waiting list, but only 5,000 livers from deceased donors become available. As a result 1,400 people die each year waiting for a liver.
Previously, all donors came from a cadaver, someone who has died and donated his or her organs. Better surgical techniques and advancements in immunosuppression improved success rates. This allowed more patients with liver disease to be eligible for a liver transplant. Unfortunately, this expansion has led to a marked shortage in cadaver donor organs. The shortage has greatly lengthened the time that recipients must wait for a liver transplant. As the waiting list has grown, so has the number of people dying while waiting for a transplant.
With living donation, once a living donor has been found, the operation can be scheduled at the donor’s and recipient’s convenience. The recipient can receive the transplant before their liver disease has progressed to a severe stage.
Using a liver from a living donor is an option for some patients with liver disease. The transplant team will determine whether this is an option based on the individual patient's health status. Using a liver from a living donor before the recipient is too ill, leads to fewer complications, faster recovery and better long-term results. A living donor transplant is also a safe procedure for donors.
Is it difficult to find a living liver donor?
Almost 50 percent of potential liver donors do not meet the strict criteria required to become a donor. They may have incompatible blood types or slight blood abnormalities. Or they may have unusual blood vessel formations in the liver that that make it hard to split the liver.
Patients often ask us about how to talk with family, friends and others about living donation. To help with this process, we have created a fact sheet called Finding a Living Donor. We hope you find this information helpful if your decide to seek a living donor.
Who can donate a liver for transplant?
The transplant team considers healthy people between the ages of 21 and 50 (may consider up to age 52 with approval by surgeon) as possible donors. Anyone interested in becoming a living donor must first be carefully evaluated. Doctors examine potential donors to help determine whether donation is the best and safest option for the donor and the recipient. Although most donors are relatives, we also consider non-relatives, such as close friends and co-workers. A donor’s sole reason for donating must be an unselfish wish to help a recipient.
What happens during a living donor transplant?
A living donor transplant begins with a surgeon removing a piece of the liver (one of two lobes, or an even smaller segment) from the living donor. Another surgeon then transplants the piece of liver into the transplant recipient who is waiting in another operating room.
If the living-donor liver transplant recipient is a child, the surgeon will remove the lateral segment of the donor’s liver (about 25 percent of the total liver). If the recipient is an adult, a larger portion of the liver needs to be removed. Usually this is the right lobe, which makes up about 60 percent of the total liver. The donor operation generally takes six to eight hours. In most cases the donor will need to stay in the hospital for five to seven days to recover. Both the donor’s and recipient’s liver grow to nearly full size in about four to six weeks.