Living-Donor Liver Transplant

A living-donor liver transplant is a surgical procedure where a portion of the liver from a healthy living donor is removed and transplanted into a recipient whose liver is failing or damaged. This procedure is also known as living-donor liver transplantation or LDLT.

Indications

Living-donor liver transplants are typically performed on patients with end-stage liver disease, such as:

• Cirrhosis
• Acute liver failure
• Liver cancer
• Biliary atresia (in pediatric patients)

Donor Evaluation

Potential living donors undergo a thorough evaluation to ensure they are suitable for donation. This includes:

• Medical history and physical examination
• Laboratory tests, including blood work and imaging studies (e.g., CT or MRI scans)
• Psychological evaluation
• Assessment of liver function and anatomy

Surgical Procedure

The surgical procedure for a living-donor liver transplant involves two separate operations:

• Donor hepatectomy: The donor undergoes surgery to remove the portion of the liver to be donated. This is typically performed using an open or laparoscopic approach.
• Recipient transplant: The recipient undergoes surgery to remove their diseased liver and implant the donated liver segment.

Types of Living-Donor Liver Transplants

There are two main types of living-donor liver transplants:

• Right-lobe donation: The donor donates the right lobe of their liver, which is approximately 60% of the total liver volume.
• Left-lobe donation: The donor donates the left lobe of their liver, which is approximately 40% of the total liver volume.

Risks and Complications

Living-donor liver transplants carry risks and complications for both the donor and recipient, including:

• Bleeding and hemorrhage
• Infection
• Rejection of the donated liver
• Liver failure or dysfunction
• Adverse reactions to immunosuppressive medications

Post-Operative Care

After the transplant, both the donor and recipient require close monitoring and care, including:

• Pain management
• Wound care
• Immunosuppressive medication management
• Follow-up appointments and laboratory tests to monitor liver function and overall health

Outcomes

The outcomes for living-donor liver transplants are generally excellent, with:

• High survival rates for recipients (approximately 80-90% at 1 year)
• Low complication rates for donors (less than 10%)
• Excellent quality of life for both donors and recipients after recovery

Frequently Asked Questions (FAQs)

What is a living-donor liver transplant?
Surgery where a portion of liver is taken from a healthy donor and transplanted into a recipient.

Who can be a living liver donor?
Healthy adult, usually a family member or close friend, with compatible blood type.

What are the benefits of living-donor liver transplant?
Shorter wait time, lower risk of disease progression, and better graft survival.

How long does the surgery take?
Typically 4-6 hours for the donor and 6-8 hours for the recipient.

What type of incision is used?
Open abdominal incision or laparoscopic approach.

Will the donor's liver grow back?
Yes, the donor's liver will regrow to its normal size within a few months.

What are the risks for the living donor?
Bleeding, infection, and potential long-term liver function problems.

How long is the hospital stay?
Typically 5-7 days for the recipient and 5-10 days for the donor.

When can the donor return to normal activities?
Usually within 2-3 months after surgery.

Is living-donor liver transplant covered by insurance?
Typically covered, but coverage varies depending on insurance provider.