Liver donation is a surgical treatment option for a damaged liver that cannot repair itself. This procedure has certain criteria a person must meet before considering donating or receiving a transplant.
Transplant centers match a donor’s liver to someone at the top of the transplantation list. Most liver donations come from deceased donors. Living individuals may donate part of their liver to a close relative, enabling them to live a typical life with a functioning liver.
This article examines how someone can donate their liver and whether the procedure is safe for living donors. We also look at the process, recovery, and potential long-term impact of a liver donation.
The most common way for a person to donate their liver is after they die. If someone wants their organs to help others after their death, they can sign up for organ donation in their state. A person must tell their loved ones about their wishes so they can organize the donation after their passing.
Some people worry that they may receive different medical treatment if they decide to donate their organs. However, someone in an accident or near death receives treatment from a different medical team than the team that would remove organs after death.
A person may donate some organs to a family member or close friend while alive. Some people may also donate to a person they do not know.
A person can donate the following organs while alive:
- a single kidney
- a lobe of the liver
- a lung or part of a lung
- part of the pancreas
- part of the intestines
Partial liver donation is major surgery and carries the usual risks of major surgery. However, a healthcare team will screen and assess any potential living donor and recipient to ensure that both people have the best chance of living a typical life after the procedure.
People may experience minor complications after surgery, and there is an emotional impact to consider if the donated liver fails. It is also possible that the donor’s remaining liver may fail. Research is ongoing into whether a person’s life may be shorter due to living organ donation.
Maintaining healthy lifestyle changes after liver donation ensures that the donor’s remaining liver has the best chance to regenerate. Doctors recommend that people avoid becoming pregnant for 12 months after liver donation.
Organ donation is the choice of the person donating. No one should force another person to undergo organ donation.
Live donors must be at least 18 years old — older at some transplant centers — and must have:
- good mental and physical health
- a body mass index of less than 35
- blood type compatibility with the person receiving the liver
- no disease, including:
- organ disease
- active substance misuse disorder
- chronic or current infections
- a support system to help with the demands of surgery and aftercare
Learn more about the criteria for live donor liver transplants.
To become a living donor, a person can contact a local transplant center.
A doctor will screen a person to ensure they are in good health and ask about recent diagnostic tests and lab work. They will also take a medical history and perform a physical examination.
A female will have a pap smear and mammogram if over age 40. A person over age 50 will have a colonoscopy.
A healthcare professional will review the tests and lab work information. The potential recipient will not have access to this information.
The potential donor will undergo evaluation and may have a family member alongside them during this process. They will meet with the transplant team and may undergo further diagnostic testing.
Doctors will check the health of a person’s heart, lungs, and abdomen with X-rays and scans. A person will also meet with a living donation healthcare team member.
A person may also meet with:
- an advocate for living donors
- a psychologist
- a liver specialist
- a surgeon
This evaluation can take multiple days, and doctors may require a person to undergo more tests after the results of earlier tests return.
An older study from 2013 examined why a team may decide that a potential donor is unsuitable for donation. The reasons included:
- donor reluctance
- a diagnosis of non-alcohol-related fatty liver disease
- assisted medical withdrawal of a donor
The transplant team will meet to decide whether surgery can take place and to check whether the donor is fit for surgery. Healthcare professionals usually schedule surgery 4–6 weeks ahead to ensure that a person can organize their work and family schedules.
Surgery can take
Donor evaluation is a detailed and rigorous process. Healthcare professionals may identify factors that can exclude a potential donor at any point. The potential donor may also change their mind at any time.
A living donor can expect to be in the hospital for around one week after surgery. Recovery is quicker for the donor than for the recipient. Living donors often return to daily activities a month after surgery and return to work after 4–6 weeks.
Physical symptoms after surgery may include:
- irritation or lack of sensation in the surgical scar
- pain in the abdomen
- irregular bowel habits
- decreased stomach tone
Living donors may experience a temporary decline in their mental health or a negative effect on sexual function and body image. This could be due to the stress of evaluation for donation.
After surgery, a donor may live a long and healthy life. However, they will not have protection from other medical problems that they would have experienced in any case.
It is illegal for a person to receive money for donating an organ in the United States.
The recipient’s private health insurance or Medicare will generally cover some of a living donor’s costs, such as the cost of:
- an evaluation of suitability for organ donation
- donation surgery
- care after surgery
Insurance typically does not cover the following costs:
- Time off work for recovery: Some people may use:
- sick leave
- state disability
- Family and Medical Leave Act (FMLA)-mandated leave
- Treatment for other conditions: While evaluating a potential donor, healthcare professionals may discover other conditions that are not associated with liver donation and require treatment.
- Non-medical expenses: Insurance does not cover the cost of travel to appointments or evaluation, lodging, or child care during recovery. Some transplant hospitals may have free or low cost hospitality services that they can offer to donors.
- Follow-up expenses: Insurance may not cover costs associated with follow-up appointments after surgery. A person can speak with the transplant center about the help available.
Some nonprofit organizations may offer help with expenses for living organ donors, including specialized life insurance.
Living organ donation can help improve the health of a person who requires a liver transplant. However, it carries the risks of major surgery.
A person considering donating part of their liver should factor in the short-term impact on their ability to work during recovery, the costs, and the availability of child care if needed.
Many people who have donated part of their liver do not regret the process and would do it again. This is particularly true if the recipient’s quality of life improves after surgery.
Some nonprofit organizations and transplant centers may offer some help to living donors. A person should research the subject thoroughly and consider the potential impact on their life before deciding to become a living donor.