Experiencing Living Liver Donation at UW Health

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There are many things to learn and think about before taking the steps to become a living liver donor. Living liver donation at UW Health is an exciting experience and we want you to understand the entire process.

 

The Living Liver Donation Process

 

Living Liver Donation Experience Step 1: Learn

 

A living donor needs support from family and friends We encourage people who are considering donation to learn more and discuss the idea with their support system before they take the next step.

 

Living Liver Donation Experience Step 2: Screening

 

Our transplant team uses an online screening tool to gather information about a potential donor's health to decide if they may be healthy enough to donate a portion of their liver. The tool asks questions about current and past health, family history and risk factors. Our team will review the responses and contact the people that can move on to Step 3, Evaluation. If people learn they are not able to move forward to Evaluation, there are many other ways they can help. (See Step 5)

 

Living Liver Donation Experience Step 3: Evaluation

 

Evaluation tests happen at University Hospital in Madison, Wis. We work to complete tests over two to three visits, but more visits may be necessary. We schedule one to two weeks between visits, to provide time for reflection. We will be very careful and thorough as we evaluate the potential donor's health. People who are very eager to donate may question the amount of testing. It's important to remember that our team must consider everything they know about the potential donor's health when deciding who could safely donate.

 

There are three parts to the evaluation:

 

1. Medical tests

  • Health history and physical exam
  • Blood and urine test
  • Chest x-ray
  • 3D reconstruction CT/CAT scan and MRCP of abdomen
  • Electrocardiogram (EKG) to record the electrical signals in the heart
  • Echocardigram
  • Other tests/consults as needed 

2. Meetings with living donor team members

  • Social Worker
  • Hepatologist (Liver specialist)
  • Transplant surgeon
  • Internal medicine physician
  • Dietician
  • Transplant nurse coordinator
  • Independent living donor advocate

3. Education about living donation

  • Donation process
  • Risks
  • Donation options
  • Surgical procedure
  • Pain management
  • After-surgery care

Living Liver Donation Experience Step 4: Review and discussion

 

After evaluation, our living donor team will review the results of all the tests. This special team of people have a lot of experience with living donation. They decide if donation is a good option for each potential donor or if more tests are needed. Their decision is shared with the potential donor. The team will answer the potential donor's questions and discuss their options for donation.

 

Living Liver Donation Experience Step 5: Decision

 

Approved to Donate

 

The potential donor is medically approved to donate a portion of their liver.

  • The potential donor is medically approved to donate a portion of their liver
  • The potential donor is emotionally prepared to donate
  • The potential donor has no psychosocial risks to donation

Not Approved to Donate

 

Our experts have decided that the medical, emotional and/or psychosocial risks of living donation are too high. The potential donor may experience a range of emotions including sadness, disappointment, relief and/or confusion. Remember, the time and effort put into this process is a powerful act of support. Transplant recipients often say that what was most meaningful to them was their loved one’s desire to help. There are other ways to help!

  • Be their champion (Learn how to be a Donation Champion)
  • Provide family and/or pet support, meals, driving assistance and/or companionship for the donor or recipient

Living Liver Donation Experience Step 6: Reflect and decide

 

At many times during the evaluation process, our team will discuss these things with the potential donor:

  • Financial considerations: It's important for potential donors to learn if donating part of their liver could affect their job or financial status in any way.
  • Caregiving and family roles: After surgery, donors will need time to recover and heal. They will not be able to do their normal household activities or care for children or other family members.
  • Body image: Donors will have scars on their abdomen after donation. Some donors say they feel different about their body and overall physical appearance. Donors can speak with their surgeon to discuss options to lessen scarring.
  • Mood changes: Some donors feel depressed or struggle to cope while they are recovering and are limited in normal daily activities. Some donors have changes in relationships with their family or the recipient of their liver.

Remember: Living liver donation is voluntary. A potential donor can choose to not donate at any time in the process. Our independent living donor advocate is ready to talk with potential donors if their decision to donate changes. Privacy is always protected, including all the potential donor's decision-making concerns.

 

Living Liver Donation Experience Step 7: Determine donation type

 

UW Health has different ways a living donor can donate. These options allow donors to donate even if their blood type, anatomy and/or timeline for surgery does not match with their intended recipient.

 

Living Liver Donation Experience Step 8: Schedule and prepare for surgery

 

After the donation decision is made, we will schedule the surgery date. Before surgery, the donor will meet with the medical team, who will check for any changes in the donor's health. They will teach responsible pain management, discuss ways to improve the recovery process and answer any questions.

 

Donors must bring these things to the hospital:

  • Any medications they take every day
  • Comfortable clothes that will be loose around the incision
  • Walking shoes

We suggest donors bring:

  • Personal and comfort items such as toothpaste, shampoo, pillows
  • Books or other things to stay busy

Do not bring any items of value.

 

Living Liver Donation Experience Step 9: Donation surgery

  1. Arrival at University Hospital
  2. First Day Surgery, third floor near F elevators
    • Drink recovery juice three hours prior to OR time
    • Meet surgeon/anesthesiology
    • Get IV placed
  3. Operating Room 6-8 hours
    • Transfer to operating table from hospital bed
    • Positioning with pillows and blankets
    • Put to sleep for surgery
    • Catheter placement
  4. Recovery Room ≥ 1 hour
    • Wake up
    • Adequate pain control
    • Memory may be fuzzy
  5. TLC (Intensive care unit)
  6. Day of surgery
    • Up and walking
    • Pain management
    • Deep breaths/coughing
    • Interrupted sleep for overnight vital checks
  7. Transplant Unit B4/6
  8. Remainder of stay (1-5 days)
    • Remove catheter
    • Walking 3-5 times/day
    • Bowel movements
    • Checking vitals
    • Pain management
    • Progress diet: From ice chips to solid food

A donor can donate either the right lobe or the left lobe of their liver. The decision is based on the size of the donor's liver and the recipient's body size.

 

This is a safe procedure, but all surgeries have risks. Risks include:

  • Significant bleeding (rare)
  • Blood transfusion (rare)
  • Return to the operating room (very rare, <1 in 100)
  • Wound complications (rare)
  • Death during the surgery (very low, estimated at 2 in 1,000 individuals)

Living Liver Donation Experience Step 10: Recovery in hospital

 

Living donors recover on the transplant unit at University Hospital.

 

Common issues for donors include bloating, nausea and tiredness, but they are up and walking very quickly and can return to a regular diet. Our team follows a rapid recovery program. With responsible pain management, donors usually go home 5-7 days after donation. Before they leave the hospital, donors are scheduled for their first follow up visit at the transplant clinic, which happens 1-2 weeks after donation.

 

Living Liver Donation Experience Step 11: Recovery at home

 

Donors may experience soreness with activity, a poor appetite and unusual bowel habits. This checklist includes important reminders to improve recovery:

  • Take as much time off from work as is needed, depending on job role
  • Use responsible pain management and don't drive while on narcotic pain medications
  • Go for a walk, but limit strenuous activities
  • Avoid constipation by eating a diet high in fiber
  • Rest
  • Contact the transplant team if needed

Living Liver Donation Experience Step 12: Return to normal lifestyle

 

Everyone recovers at their own pace. Most donors return to their regular lifestyle by 8-10 weeks after donation. We encourage all donors to be committed to their health and wellness. We recommend a healthy diet and exercise to support good health and liver recovery. Six months after donation, and annually near the donation date, donors must complete blood and urine tests and have their blood pressure checked. For their lifetime, we recommend donors have an annual physical, including blood pressure monitoring.

 

Becoming Involved After Donation

 

Living donors often seek ways to stay connected to the mission of organ, tissue and eye donation, transplant and living organ donation. UW Health welcomes your support and offers these suggestions:

  • Share your story using our online form at uwhealth.org/mytransplantstory
  • Use social media to stay connected and support living donation. See the many channels where UW Health is active at uwhealth.org/social
  • Join our Volunteer Program at uwhealth.org/OTDvolunteer. Learn the facts about deceased and living donation and volunteer time to support donation education and outreach activities in Wisconsin.
  • Become a Mentor. Living donors are paired with people who are considering live donation to share their experience and help others during their decision-making process.
  • Be a Living Liver Donation Champion. Help potential recipients who need someone to help them find a living donor. Learn how you can be a Living Liver Donation Champion.
  • Join our Patient and Family Advisory Council. This team works to improve the patient experience by sharing feedback with our transplant professionals. Learn more about the Patient and Family Advisor Partnership Program.