Live donor liver transplantation (LDLT) is a procedure that involves a living donor giving a portion of his or her liver to a family member or close friend in need of a liver transplant.
Candidates, or recipients, are those individuals with advanced but stable liver disease who have been accepted and listed as appropriate cadaveric liver transplant recipients.
After being accepted and listed as a cadaveric transplant candidate, the transplant team will review your medical information to determine whether or not LDLT is a potential option for you.
Donors are relatives or close friends with a significant emotional tie to the recipient. They must have a compatible blood type and body size, as determined by the recipient's height and weight. In addition, donors must be between the ages of 18 and 60. They must also test negative for active or chronic hepatitis B and C and can have no serious medical conditions such as diabetes, cancer or heart disease.
After initial screening blood work is received and reviewed, a potential donor is scheduled for a consult with a transplant nurse and surgeon. This consult involves a discussion of the procedure itself, as well as an opportunity for the donor to ask any questions. The potential donor is then scheduled, along with the recipient, for a CT scan to evaluate liver volume and vascular anatomy. More extensive blood work is also completed at this time. If the donor is accepted based on his or her liver anatomy, a comprehensive two-day evaluation is then scheduled. This evaluation includes an ultrasound, preoperative testing, and consults with a physician, psychiatrist and social worker. If a potential donor completes this evaluation and is accepted as a suitable donor, surgery is scheduled.
Surgery is typically performed approximately 2 to 4 weeks after the evaluation has been completed.
Simultaneously, two separate surgical teams perform the donor and recipient surgeries. As one team works on removing the diseased liver from the recipient, the other is working on removing a portion of the donor's healthy liver. Typically, the right lobe of the donor's liver is removed, which accounts for approximately 60 percent of total liver volume. Once the healthy liver has been removed, it is then implanted into the recipient. The donor surgery typically takes about 6 hours, and the recipient surgery about 5 hours.
Our family waiting room is staffed by a nurse liaison who will provide frequent updates to the families of the recipient and donor throughout the surgery.
Following surgery, the donor and recipient are taken to the Post-Anesthesia Care Unit (PACU) for careful monitoring by physicians and nurses. The recipient will wake up with a breathing tube in place. Doctors and nurses will check the functioning of the recipient's new liver frequently through blood tests, urine and bile production measurements and other tests, as needed. Once the donor or recipient's condition is stable, he or she is moved to the transplant unit for the remainder of his or her hospital stay.
The average recipient will be in the hospital for 10 to 14 days. The average donor will be in the hospital for 7 to 10 days.
The recipient will need to stay in the area for 6 to 12 weeks following hospital discharge for weekly blood work and visits to the transplant clinic. The donor will need to stay in the area for approximately 1 week following discharge.
Donors must return for follow-up appointments at 1 month, 3 months, 1 year and 2 years.
Insurance coverage for liver transplant surgery differs, depending on your insurance carrier and your specific health plan. Please refer to the "Financing Your Transplant" section of our site or contact financial coordinator Pat Hogan at 781-744-2500 with any insurance-related questions.
For further information, please contact Denise Morin, MSN, RN, at 781-744-2500.
Health Resources and Services Administration (HRSA) Awards Lahey Clinic the Silver1 Medal of Honor for Organ Donation.