Living Donor Liver Transplant
A living-donor liver transplant involves transplanting a portion of the liver from a living donor into a recipient whose liver no longer functions properly.
Living donor liver transplant is a surgery in which the donor is alive and he is willing to donate liver to the patient. Living donor liver transplant has grown rapidly in India. The cost of living donor liver transplantation in India is varying between Rs. 10 to 20 Lakhs.
The donor's remaining liver regenerates itself and returns to its normal volume and capacity within a couple of months after the surgery. Meanwhile, the transplanted liver portion grows and restores normal liver function in the recipient.
Why living donor liver transplant is done
The number of people waiting for a liver transplant greatly exceeds the number of available deceased-donor livers.
Living-donor liver transplant provides an alternative to waiting for a deceased-donor liver to become available. Having a living liver donor also allows the recipient to avoid potential health complications associated with waiting for transplant.
Living-donor liver transplants are more common among children needing a liver transplant than among adults due to the scarcity of appropriately sized deceased-donor organs.
Most living liver donors are close family members or friends of the liver transplant candidates.
What you can expect
Before the living donor liver transplant
To be considered for a living-donor liver transplant, both the donor and recipient must undergo a thorough health and psychological evaluation at a transplant center. Separate transplant teams will care for the donor and recipient during the evaluation process and will discuss the potential benefits and risks of the procedure in detail.
For example, while the liver transplant is often potentially lifesaving for the recipient, donating a portion of a liver carries significant risks for the donor.
Matching of living-donor livers with recipients is based on age, blood type, organ size and other factors.
During the living donor liver transplant
On the day of liver transplant, doctors first operate on the donor, removing a portion of the liver for transplant. Then doctors remove the diseased liver and place the donated liver portion in the recipient's body and connect the blood vessels and bile ducts to the new liver.
The liver transplanted in the patient as well as the portion left behind in the donor regenerates rapidly, reaching normal liver volume and function within a couple of months.
People who receive a liver from a living donor often have better short-term survival rates than those who receive a deceased-donor liver. But comparing long-term results is difficult because people who have a living donor usually have a shorter wait for a transplant and are not as sick as those who receive a deceased donor liver.
Who can donate liver?
Living donor liver transplantation is a surgery in which a liver is donated by a human being who comes under the criteria for living donor liver transplant. There are some frequently asked questions regarding living donor liver transplantation.
Q. Liver can be donated by whom?
A. The person who is willing to donate his/ her must be a close relative.
Q. Liver can be donated with a motive of?
A. The person who is donating liver for living donor liver transplantation must donate of his/her own free will without financial motivation.
Q. What is the eligible age to donate liver?
A. The age which is eligible to donate liver for living donor liver transplantation is 18 - 55 years.
Q. Which donor-recipient duo is compatible for liver transplant?
A. The donor and recipient blood groups and human leucocytes antigen (HLA) profiles must be compatible although nowadays blood group incompatible and HLA profile incompatible transplantations are being performed by some centers using strict immune-suppression protocols for living donor liver transplant.
Q. Does the donor have to undergo any investigation prior to any liver transplantation?
A. The suitability of the donor for living donor liver transplantation in the respects and other detailed medical evaluations is determined by a multi-disciplinary team of health professionals during the pre-transplant donor evaluation which normally takes 3 to 4 days by subjecting the donor individual to an array of investigations like CT scan, MRI etc.
Tests during pre-liver transplantation
There are various tests which are prescribed by doctors to surgeon during pre-liver transplantation. Tests which are prescribed by doctors are as follows:
Laboratory tests are prescribed by doctors to assess the health of your organs, including your liver which includes blood tests, urine tests.
Imaging tests are prescribed by doctors which are Ultrasound, CT scan, MRI of the liver and other abdominal organs.
Heart tests are prescribed by doctors to determine the health of your cardiovascular system.
A routine cancer screening is a general health exam to evaluate overall health of a donor.
Psychological evaluation is prescribed by doctors to determine whether you fully understand the risks of a Liver Transplant.
Addiction counseling is prescribed to help people with alcohol, drug or tobacco addictions to quit.
Precautions taken post-liver transplant surgery
There are some precautions which are to be taken by the donor as well as recipient. Precautions which are to be taken by the donor and recipient are as follows:
•    The donor must stay under observation post-liver transplant surgery in hospital for 2-3 weeks.
•    At home, 2-3 weeks of recuperation for donor is needed after discharging from hospital.
•    A donor can resume his/her normal activity 6-8 weeks post-liver transplant surgery.
•    Sexual activity can be resumed when the doctor gives an affirmative nod for it or when the donor feels well enough post-liver transplant surgery.
•    Heavy physical exercise, sports including lifting weights can be resumed 3 months post-liver transplant surgery.