Living liver donation: You can trust our experts in living liver donation

Living donation can happen as soon as a donor is found, approved and ready to donate. Getting a liver donation quickly is important for many people who are waiting for a liver transplant. Living with liver disease is very difficult and livers from a deceased donor are given to the sickest patients waiting. Almost 14,000 people are waiting. Getting a liver from a living donor allows patients to get a liver before having to become so ill. Other reasons why a living liver donation is better are:

• The recipient will get transplanted sooner and won’t become sicker while they are waiting for a deceased donor liver.

• Living liver transplants are scheduled which makes recovery easier.

• The liver is a great match and from a person who has been tested to ensure they are very healthy.

• Recipients of a living donor liver have better survival rates than those who receive deceased donor livers.

A donor and recipient do not have to be related. They just need compatible blood types.
If you are older than age 18 and in good physical and emotional health you can apply to be a living donor. Donors are often family members or close friends, but it's not unusual for a stranger to be a good match. The best matches happen when the donor and recipient have similar body size and organ anatomy. A liver from a younger person will regenerate faster. We offer two options for living liver donation.

Most expenses, including your donation evaluation, tests and surgery, are paid by the recipient's insurance. You will pay for your own travel expenses including food, gasoline and hotel. You will need time off from work and may not have paid leave for this use. Our social workers tell you what costs to expect, share information about tax benefits and explain ways to get help with expenses.

Not everyone who considers donation can or will donate. Our Independent Living Donor Advocate represents you, the donor, to make sure your decision remains private. They are responsible for representing your wishes, discussing any issues and being your advocate.

If you would like to speak to someone who was a living donor, please call us at (608) 263-1384 and ask about our living liver donor mentor program.

It's easy to assume that if you wanted to help, you would just offer to donate. In fact, you may be waiting to be asked or might think someone else is already going to donate. You may want to do some reading about living liver donation. We support communication that clearly states that a living liver donor is needed.

If you or a loved one needs a liver transplant, quickly tell your close family and friends that a living donor liver transplant is the best option. Some people who need a liver transplant have a living donor champion - a person or people who help get the message out further. Our education materials will improve their chances of finding a living donor.

Patients and living donor champions should let people know why a living donor transplant is needed.

1. Explain why a liver transplant is needed and how liver disease is affecting the patient's life.

2. State why living donation is the best option. Read our Introduction to living liver donation to learn important facts.

3. Highlight that a living donor does not have to be related to the recipient or have the same blood type. Our options for living liver donation explain the ways anyone who is healthy enough to donate can donate.

There are many ways to share the story:

• Carry our wallet card and give it to people so they can learn more

• Telephone friends/start a phone tree

• Make a video

• Post a flier

• Local newspaper story

• Radio ad

• Billboard

• Write a message on a car window or t-shirts, get creative!
  

If you know who the recipient of your donation is, it is a direct donation. The recipient may be your family member, friend or someone from your community.

Non-directed donation happens if you do not know who will receive your liver donation. Your liver donation goes to the person it best matches who is most in need.

Read our living liver donation website and discuss it with your support system.

We use this online screening tool to gather information about your health to decide if you are healthy enough to donate a portion of your liver. The tool asks questions about current and past health, family history and risk factors. Our team will review the responses and contact you. If you learn you are not able to donate, there are many other ways you can help.

Evaluation tests happen at University Hospital in Madison, Wis. You will have 2-3 visits, or more if necessary. We schedule 1-2 weeks between visits, to give you time to think about donation. We are very careful and thorough in this evaluation. If you are very eager to donate you may question the amount of testing. Remember that our team must consider everything they know about your health when we decide if you can 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

   • Echocardiogram

   • 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
     

After evaluation, our living donor team will review the results of all your tests. This special team has vast experience with living donation. They decide if donation is a good option for your or if more tests are needed. We will share information with you, answer your questions and discuss options for donation.

You are approved to donate a portion of your liver if you are medically approved, emotionally prepared and have no psychosocial risks to donation. If you are not approved to donate, it’s because our experts have decided that the medical, emotional and/or psychosocial risks of living donation are too high. You 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. You can still help the recipient by being their donation champion and/or by providing family and/or pet support, meals, driving assistance and/or companionship for the donor or recipient.

This is the time when you will make your final decision about donating a portion of your liver. You can choose to not donate at any time in the process. Our independent living donor advocate is ready to talk with you if your decision to donate changes. Privacy is always protected, including all your decision-making concerns. We will also discuss financial considerations, caregiving and family roles and the support you will need while healing. We will also discuss body image, because you will have scars on your abdomen and 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.) Some donors also experience mood changes and 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.

UW Health has different ways a living donor can donate. Some may be better for you or the recipient. These options allow you to donate even if your blood type, anatomy and/or timeline for surgery does not match with your recipient.

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

You must bring these things to the hospital:

• Any medications you take every day

• Comfortable clothes that will be loose around the incision

• Walking shoes

We suggest you bring:

• Personal and comfort items such as toothpaste, shampoo, pillows

• Books or other things to stay busy

Do not bring any items of value.

The big day! This is an outline of your surgery day:

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

You donate either the right lobe or the left lobe of your liver. The decision is based on the size of your 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)
  

You will recover on the transplant unit at University Hospital. Common issues for donors include bloating, nausea and tiredness. You will be up and walking very quickly and can return to a regular diet. Our team follows a rapid recovery program. With responsible pain management, you will go home 5-7 days after donation. Before you leave the hospital, you will be scheduled for your first follow-up visit at the transplant clinic, which happens 1-2 weeks after donation.

You 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
  

You will recover at your own pace. Most donors return to their regular lifestyle by 8-10 weeks after donation. We encourage you to be committed to your 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, you must complete blood and urine tests and have your blood pressure checked. For your lifetime, we recommend that you have an annual physical, including blood pressure monitoring.