Live Liver Donation Frequently Asked Questions

UW Health's Transplant program at UW Hospital and Clinics in Madison, Wisconsin features a living liver donor program. Refer to the FAQ resource below to answer any questions you might have about the program.

Q. What are the advantages to having a living donor?

A. Advantages include:

• Decreased wait time, especially for people with less severe liver disease
• Allowing patients to return to a better quality of life in a much shorter time period
• Scheduled surgery, making it more convenient for patients and their families

Q. What are the risks involved with being a living donor?

A. While the results of adult-to-adult living donor liver transplantation throughout the world are very good, the procedure is not without risk to the donor. The risk of dying from donating a portion of the liver is estimated to be 1 in 200. Potential risks of this surgery include, but are not limited to, the list below.

• Reaction to the anesthesia given during the surgery
• Stroke or heart attack
• Blood clots in the legs or lung
• Fluid around the lung or collapse of a lung (pneumothorax)
• Fluid retention (edema)
• Mild or severe infections, such as pneumonia, urinary tract infections, or wound infections
• Bleeding requiring blood transfusions
• Repeat operations
• Bile leakage or bile duct complications
• Injury to other organs such as the spleen, stomach, or intestine
• Injury to the remaining liver blood vessels or bile ducts resulting in liver failure and the chance of needing a liver transplant
• Unsightly scar
• Pain in the incision that doesn’t go away
• Problems with wound healing
• Hernia
• Bowel problems such as slow or blocked bowels

There are also non-medical risks to consider. These may include:

• Financial strain and potential impact on your job: You should plan on being off work for eight to 16 weeks. It is possible that donating part of your liver will effect your job status long term.
• Problems getting insurance in the future: This can include health insurance and life insurance.
• Changes in your mood: This includes things such as adjustment disorders, anxiety, or depression.

Q. What are the risks for the recipient?

A. Living donor transplant is a more complex surgery. There is an increased risk for complications when a person gets a live donor liver transplant, specifically bile duct complications, when compared to a brain dead donor. Most complications can be treated. However, there is a risk that complications will lead to graft loss or death.

Graft survival rates refer to how long a liver works. 3 year and 5 year graft survival rates are lower for living donor livers than for livers from brain death donors.

Q. Does the donor need to be a relative?

A. Through the medical miracle of live-donor liver transplantation, people do not have to be blood related and any healthy person can give a friend or relative the gift of life. However, we do require that donors have an emotional relationship with the intended recipient.

Q. Who can be a donor?

A. The UW Health Transplant staff carefully reviews each person's situation to see if they are a suitable donor.

• A living donor can be related or un-related, and must have an established relationship with the intended recipient
• A donor is most often between 18 and 55 years of age. A donor must be old enough to provide informed consent and young enough to have a healthy liver
• The donor’s main goal should be to help the recipient
• Living donation must be a voluntary choice without outside pressure, coercion, or material gain
• The donor must be in excellent physical and emotional health. The donor must be free of major health issues
• The donor must have a blood type that is compatible with the recipient’s blood type
• Donors must have a body mass index less than 35
• A donor cannot have cancer
• A donor cannot have any active infections
• The donor must have normal or near normal liver function and have no history of any liver disease
• Anatomical differences occur among persons. The donor’s liver must have a pattern of blood supply and a distribution of bile ducts that are suitable for transplant.
• The donor must have family or friends that can provide support before, during, and after the surgery
• The donor must be able to plan for up to three months off from work
• The donor must be able to express understanding of the risks of living liver donation
• A donor is required to have a primary care doctor
• A donor is strongly encouraged to have his or her own health insurance. Lack of health insurance may exclude a person from being a donor
• Costs related to donating are billed to the recipient’s insurance. Any questions about the financial aspects of donating can be direct to the transplant financial coordinator at (608) 263-1505.
• Keep in mind that not all patients that need liver transplant can receive a live donor liver, so this will also need to be assessed

Q: May I get my evaluation done by my own doctor?

A. Generally, the tests are done at UW Hospital and Clinics. If you live at a distance, we may have some portions of the initial evaluation done near your home. The evaluation process will, however, require visits to UW Hospital and Clinics and the surgery must be performed here.

Q: What will the surgery involve?

A. Potential live liver donors are educated on the risks associated with surgery, hospitalization, and recovery. The surgery to remove the portion of a donor's liver takes about five hours and the donor stays in the hospital for about seven days. Typically, the right lobe of the donor's liver is removed. During the surgery about 40 to 60 percent of the donor's liver is removed. The liver begins to regenerate almost immediately. Most of the regeneration occurs in the first two weeks after the surgery, followed by a slower phase of growth over the next year.

Q: Will I have much pain after the surgery?

A. Unfortunately, you will have significant pain after the surgery. We will give you pain medication but you will still be very uncomfortable for at least the first week. You will have less pain as each day goes by, but most of our donors have a significant amount of discomfort for two to four weeks after surgery. Most pain medications make you drowsy, can affect your breathing and may cause nausea and constipation. We will try to find the right balance of pain medication to make you comfortable.

Q. What are the costs for the donor?

A. The recipient's insurance pays for all donor medical expenses related to donation. Travel costs and time away from work are often not covered by insurance and need to be considered. Costs to the donor include:

• Time off work
• Medications such as pain pills after the surgery
• Transportation for visits
• Non-hospital lodging costs, if needed

Donors that live in Wisconsin may subtract up to $10,000 from their federal adjusted gross income for these costs on their state income tax form. An employee of the state of Wisconsin may also receive 30 days paid leave of absence for donating a solid organ.

Q. What about donor care after donation?

A. The donor will be seen for a follow-up visit by the surgeon two to three weeks after donation, then again at one year and two years after donation. Donors should have routine annual medical exams with their local doctor. There are no special diets or medicines that need to be taken after liver donation.

Q. How long is the living liver donor in the hospital and out of work?

A. The hospital stay after donor surgery is on average five to eight days. Most people are able to return to work after eight weeks, depending on how the surgery goes and the type of job they have. We advise donors to plan to be off of work for eight to 16 weeks. If the donor has a desk job, he/she may be able to return to work sooner than patients with a more physically demanding job.

Q. What happens if I decide not to become a living liver donor?

A. If you decide not to become a donor, the recipient will remain active on the transplant list. The recipient also may choose to find another potential living donor.