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?
A surgical procedure where a portion of a healthy person's liver is removed and transplanted into a recipient.

Who can be a living liver donor?
Typically, a family member or close relative with a compatible blood type and similar liver size.

What are the benefits of a living-donor liver transplant?
Reduced wait time for a transplant, potentially improved graft survival, and emotional benefits for both donor and recipient.

What are the risks for the living liver donor?
Risks include surgical complications, infection, bleeding, and potential long-term liver function issues.

How long does it take for the donor's liver to regenerate?
The liver typically regenerates to its original size within several months to a year after donation.

Can anyone be a recipient of a living-donor liver transplant?
Generally, recipients are those with end-stage liver disease or acute liver failure who meet specific medical criteria.

What is the survival rate for living-donor liver transplant recipients?
Survival rates vary depending on factors like recipient health and underlying condition, but generally around 80-90% at one year.

How long does the living-donor liver transplant surgery take?
Typically, the surgery can take around 4-6 hours for the donor and 6-12 hours for the recipient.

Do living liver donors require ongoing medical care after donation?
Yes, donors typically require follow-up care to monitor liver function and overall health.

Is living-donor liver transplantation covered by insurance?
Coverage varies depending on the insurance provider and specific policy, but often it is covered as a medically necessary procedure.