Living liver donation

Living Liver Donation

Living donor liver transplantation is currently the best way of receiving a liver transplant in India due to the severe shortage of brain-dead deceased donation in our country. In this process, a healthy person who is a close family member of the patient voluntarily comes forward to donate a part of his/her liver to their patient. Any healthy individual aged from 18 years to up to 50 years of age can be a liver donor.

Liver Donor assessment process

The prospective liver donor undergoes a battery of tests to assess their fitness to proceed with donation. These include blood tests to assess his/her medical condition, heart and lung function, CT and MRI scans to check the size and health of their liver and calculate the size of the liver portion which can be safely donated. Once the entire workup is completed, the reports are discussed in a multi-disciplinary team before the donor is approved. The process takes 2-3 days, and each donor is assigned a coordinator to help them during every step of the process.

Live Donor hepatectomy

The portion of liver which is donated by the donor depends on several factors. The most important aspect is the safety of the donor. As a rule, at least 30% of the donor’s liver is left with the donor after the operation. This amount of liver is sufficient to grow back to its usual full size in 4-6 weeks while supporting the liver function. The actual amount of liver donated is usually smaller and depends on the weight of the patient. Usually, the smaller left part of the liver is donated when a child is being transplanted, while the right part of liver is donated for an adult patient.

The surgery is performed using open surgical technique and takes 5-6 hours. The patient is cared for in the ICU for 2 days after surgery and is then shifted to ward level care. Most donors are fully independent and can take normal diet by the 3rd or 4th day after surgery. They are usually discharged 5 to 6 days after the operation.

Risks of Liver Donation

Live donor hepatectomy is a safe and highly standardised procedure. Precautions are taken at every point right from initial testing until discharge to ensure that the post-surgery course is smooth and uneventful. Minor complications such as nausea, post-operative pain at the incision site can occur in about 10% of donors and can be easily managed with medications. About 2 out of 100 donors may need additional procedures during post-surgery admission. The risk of serious complications, including donor death, is very low and is reported in 1 out of 300 to 500 donor operations.

Life after Donor Hepatectomy

The remaining liver will grow back to its original size in 4-6 weeks. Normal work can be resumed one month after surgery, but donors are advised to avoid heavy exertion for three months. There are no long term restrictions after live donor hepatectomy, and the donor is free to eat, travel, study and work as normal. Donors can have a normal family life, and female donors can get pregnant safely after liver donation.

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