[MUSIC PLAYING] In the United States, there are more than 14,000 people currently on the liver transplant waiting list. Living donor liver transplantation is an alternative solution for the long wait times for a deceased donor since a transplanted segment of the liver is able to regenerate or grow back within a few months. With one of the most experienced liver transplant programs in the Midwest, the University of Chicago Medicine offers patients a leading-edge approach to transplantation through living donor liver transplantation.

The ideal living donor is an individual between the age of 18 to 55 who isn't obese and hasn't had any major abdominal surgery. The donor's blood type must also be compatible with the recipient but not necessarily matching. Both donors and recipients will undergo blood work, a CT scan of the liver, which determines the shape of the liver and the blood vessel anatomy, and an EKG to rule out any potential heart conditions.

Once a donor has been deemed acceptable, the donor and recipient will meet with hepatologists and transplant surgeons to discuss the surgery. Patients who receive a liver from a living donor often have better short-term and long-term survival rates. Surgeries on the donor and recipient take place in separate but nearby operating rooms so the liver segment can be easily transported to the recipient.

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The medical and surgical teams are in constant communication during the surgeries. On the day of transplantation, surgeons will make an incision in the middle upper part of the donor's abdomen and will carefully isolate veins and divide the liver. The segment of the liver taken depends on the size of the donor's liver and the needs of the recipient. But typically, about 60% to 70% is taken. In a separate operating room, surgeons will make an incision under the rib cage and remove the recipient's entire diseased liver.

Once the recipient is ready to receive the liver, the donated portion is brought to the operating room and placed in the recipient's body. Blood vessels and bile ducts are then connected to their appropriate counterparts. The transplanted liver in the recipient and the portion left behind in the donor will regrow reaching normal liver volume and function within approximately six weeks.

Donors will typically stay in the hospital five to six days following surgery and may have to wait six to eight weeks to return to a job that requires physical activity. Recipients may be able to return home after one week in the hospital and will continue to recover for one to three months after surgery. Recipients will continue to work with our hospital team and will have annual follow-ups with their hepatologist.

UChicago Medicine also offers transplant patients a team of support staff, including social workers, pre and post-transplant coordinators, dietitians, and pharmacists. Our care team members will support you each step of the way. To learn more or to make an appointment for a liver transplant evaluation, visit uchicagomedicine.org/liver-transplant, or call 773-702-4500.

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Every year in the United States, people with liver failure die waiting for a transplant because the need for donor organs is greater than the number of livers available for transplantation. Waiting for a donor liver from the United Network of Organ Sharing (UNOS) is not the only option available to liver failure patients. Because of the liver’s amazing ability to regenerate, living liver donors can give part of their healthy liver to a transplant patient and end their long wait for treatment. Living liver donations can save the lives of countless people with end-stage liver disease.

Read our Tips for Finding an Organ Donor

The University of Chicago Medicine has been an important pioneer in the field of liver transplantation. In 1989, our surgical team performed the first successful living donor liver transplant: a parent gave part of her liver to her daughter.

Evaluation and Assessment

If you are considering living liver donation, our liver team will meet with you to discuss the procedure and evaluate your health. During your assessment, you meet with members of the liver transplant team and other medical staff as you go through a series of tests and procedures to help decide on whether you are a good candidate for living liver donation.

Read more about living donor transplant for liver cancer patients.

Frequently Asked Questions About Living Donor Liver Transplant

No. Although many people end up donating a part of their liver to someone in their family, it’s important to know that a person can choose to donate their liver to anyone, be they a friend, coworker or stranger.

Read our Tips for Finding an Organ Donor

In the United States, more than 13,000 people are on the waiting list to receive a liver, but approximately 1,500 patients die waiting for one each year. A living liver transplant can offer a potential recipient the chance for a transplant in a timely and intentional fashion.

Living liver donor surgery can be scheduled when the transplant recipient is in better health — ideally, before the onset of life-threatening complications — and help him or her have the best chance for a successful transplant.

Are you Eligible to be a Living Donor?

This questionnaire is for friends, family and others who are considering being a living donor.

Take our living donor questionnaire

Information for Liver Donors

The liver transplant team at the University of Chicago Medicine is committed to safety and excellence in living donor liver transplant. Choosing to become a living liver donor is an important, personal decision, and we are here to answer any questions you have about living donation.

For an overview of living liver donation and an introduction to the donation evaluation process, watch our Living Donor Liver Transplant Education Video. If you have any questions, please contact our living donor coordinator or another member of the transplant team. They will answer your questions when you come in for an evaluation appointment.

If you are considering becoming a living liver donor, there are several requirements you must meet.

You must be between the ages of 18 and 55.

You must be willing to donate your liver of your own free well.

You must have: 

  • a healthy, normal functioning liver
  • no significant medical illnesses
  • a liver anatomy that is safe for donation (this is determined through sophisticated imaging)
  • a compatible blood type to the recipient

You do not have to be related to the recipient to whom you would like to donate part of your liver.

If you’ve decided to be a living liver donor, you’ll go through a detailed evaluation process that includes blood tests and imaging studies to check the quality and anatomy of your liver. You’ll also meet with members of the liver transplant team and other medical specialists. These consultations, tests and procedures will rule out any medical, surgical, psychological or social barriers that would prevent you from safely donating part of your liver and help us determine whether you’re a good candidate for living liver donation.

As you begin the donation process, you’ll be assigned a living donor advocate and a nurse coordinator, who will help you navigate the evaluation process and answer any questions or concerns you may have.

Prior to surgery, you will be asked to refrain from certain activities to increase the success of the liver transplant:

  • If you smoke, you should stop smoking at least one month before the surgery. Smoking adds risk to the surgery for both you and your recipient.
  • Refrain from alcohol and drugs before surgery for at least one month.
  • Tell your nurse coordinator about any medications you take.
  • If you’re taking birth control pills, stop using them at least six weeks before the surgery in order to prevent dangerous blood clots after the operation. You may wish to consult with your gynecologist about alternative forms of birth control to use in the meantime.

During the procedure, your surgeon will determine how much of the liver is removed based on the age and size of the patient receiving the transplantation. If you are donating to a patient who requires a larger donor liver, your surgeon may take your right lobe, which is roughly 60% of your overall liver. For patients who require a smaller donor liver, you might donate the left lobe, 40% of your liver. After surgery both you and the transplant patient will have partial livers that will grow to provide normal liver function.

After surgery, you’ll be monitored closely for the first 24 hours. The next day, you’ll be transferred to the transplant floor where you’ll stay for up to one week to begin your recovery.

As with any major surgery, liver donation surgery can include complications. At UChicago Medicine, safety is our main priority; our team will evaluate all of the potential risks and discuss them with you before the procedure.

All medical costs related to donating a part of your liver are covered by your recipient patient’s insurance. If you’re being evaluated for or undergoing a living liver donation, the National Living Donor Assistance Center may help you with reimbursement for travel, lodging and food expenses. People who may not otherwise be able to afford to donate are given priority.

John Fung, MD, PhD

What you should know about living liver donation

Read the full article

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Living Donor Liver Transplant