Liver Transplantation

Things To Consider

What Should Potential Donors Know?

Here are some things you should know if you want to be a living donor:

• A healthy liver can regenerate unlike any other organ in the body. Thanks to this unique function, healthy living donors can donate a portion of their liver to a recipient and their liver will grow back. 
• All information you provide during your workup is confidential and will not be discussed with the intended recipient, as per law (HIPAA) and our hospital policy.
• As a donor, data about your case will be sent to UNOS (United Network of Organ Sharing), the federally designated transplant organization. Other party communication throughout the transplant process will be done as permitted by law and may be subject to authorized release of information.
• You have a responsibility to honestly and fully report any and all health concerns, issues, and behaviors that might either affect your ability to be a donor or pose health risks to the recipient.
• You have a responsibility to tell the donor team about any homeopathic or herbal remedies you are taking. These supplements may interfere with liver function, in addition to any medications you may be taking.
• If our screening shows that you have major health issues, we may ask you to give consent for us to get reports from your doctor before we start your workup.
• The length of the workup depends on your schedule and how complex your health issues are. It may take days, weeks, or even months to complete all the components that are needed.
• If you wish to talk with someone who has had liver donor surgery, please let us know. We will be happy to set up a time for you to talk with a liver donor.

Benefits & Risks for the Living Donor

As with any medical procedure, there are risks associate with living organ donation, no matter how carefully the donor surgery is done. If you are thinking about donating an organ, you need to have a good understanding of what the surgery involves, the benefits and risks, and the potential changes/effects it may have on your life.

• There is no medical benefit for donating part of a liver; however, there can be personal psychosocial benefits by experiencing the satisfaction of knowing that you contributed to the improved health of the recipient.
• After donor surgery recovery, there is the ability to live a happy, healthy, normal, active life.
• Donation does not change life expectancy.

During your evaluation process, you will hear a lot about the risks of donor surgery. Our transplant team will carefully review the following risks during your pre-surgery visits:

Surgical Risks

Risks that are inherent in all surgeries may be temporary or permanent. The majority of risks to a potential living liver donor are due to effect of anesthesia. However, additional risks related to any surgery can include but are not limited to: death, hernia, bleeding, bowel obstruction, severe scarring, and pain.

• There is an average 35% risk for overall complications from partial-liver donation.
• Risk of death from right lobe liver donation is 0.5%.
• Risk of death from left lobe liver donation is 0.1%.

Health Risks

Along with surgical risks, any time a section of liver is removed there are a few areas of risk to monitor for:

• There can be a blockage of the blood vessels or the bile duct (called a stricture) by a clot or by the forming of scar tissue. This may require a specialized X-ray procedure or going back to surgery to open the vessel or duct.
• There may be a blood, bile, or fluid leak from the surface of liver where the section was removed. This may delay healing or may need to be removed in a specialized X-ray procedure or by going back to surgery.
• A healthy liver now does not guarantee a healthy liver in the future. Maintaining healthy lifestyle choices will help ensure your liver remains healthy throughout your life.

Psychosocial Risks

• Problems with body image, depression, or anxiety may occur after donation.
• If the transplant is unsuccessful — the recipient dies or experiences liver failure after the transplant — you may experience emotional distress or grief.

Job Security and Health Insurance

• You and your health insurance company are responsible for future long-term follow-up after your donation and any future health problems you may develop, as they may not be covered by the recipient’s insurance.
• There is a possibility that your donation could have a negative impact on your current employment, leading to loss of income or the ability to obtain future employment. In addition, during the evaluation, we may discover certain abnormalities that will require more testing or treatment at your expense. After donating a portion of your liver, health insurance companies may consider you to have a pre-existing condition and may refuse payment for medical care, treatments, or procedures. In addition, your premiums for health, life, and disability insurance may increase. You also may find it harder to obtain, maintain, or afford health, life, and disability insurance if you currently do not have them.

Psychosocial Support

The UI Health Transplant Team has a dedicated Living Donor Advocate and social worker available to assist you and your family throughout the donor process. It is common for donors to have questions and concerns during the evaluation process. Some common issues potential donors face:

• Stress associated with considering donation
• Worries about financial responsibilities when work is missed
• Uncertainty over childcare and housing for family during hospitalization
• Potential lack of support after surgery during the recovery phase

Whether the recipient is a family member or friend, the decision to consider donation can raise conflicting emotions. Our transplant team is very committed to addressing all concerns in a private and confidential manner. Our social worker will meet with you at the beginning of your evaluation and will continue to be available to you throughout the evaluation process, during your hospitalization, and after you return home. It is important to remember that a donor can change their mind about going through with donation at any point before the surgery, even the day of surgery. The transplant team will support whatever decision a donor makes at any point in the process.

Your decision will be kept confidential and will not be shared with the intended recipient or anyone else.