The pros of live liver donation include the following:
- Gift of life – By choosing to become a liver donor, you’re giving the priceless gift of life to a loved one. By being their live donor, you’re shortening the time they spend in sickness while on a liver transplant wait list, and increasing their time living a healthy life. At the same time, you’re increasing the likelihood of a successful transplantation, since at Lahey transplant survival rates are higher when the liver transplant comes from a live donor. Additionally, you’ll be helping another wait-listed patient, since you’ll be opening your recipient’s spot for the next person on the list when a deceased liver becomes available.
- Liver regeneration – The liver is the only internal organ capable of full regeneration. This means that the remaining portion of your liver will grow to maintain your body’s functions. As little as 25% of your liver can regrow to its original size. After you donate, your liver function returns to normal in two to four weeks, and your liver will slowly regrow to nearly its full original size in about a year. This regenerative property is the essence of live donor liver transplantation.
- Low financial burden – The entire donation process is typically paid for by the recipient’s insurance company. This includes all pre-transplant evaluations, the surgery, in-hospital recovery and follow-up care. This can be of great relief to you, as it removes most financial limitations that you might have otherwise had. Some items, such as painkillers, may not be covered by the recipient’s insurance company, so our financial coordinator will identify how to pay for them.
The cons of live liver donation include the following:
- Time commitment and personal risk – Donating a portion of your liver is an invasive surgery that you do not medically require. It will take time and personal effort to recover. The pre-transplant evaluation is a necessary and time-consuming process that will take you away from other activities. Your hospital stay will last from 4 to 7 days, but you but you likely will not be able to return to work or school until 6 to 12 weeks after hospital discharge.
- Pain – Pain is, unfortunately, inevitable with any surgery of this magnitude and will occur even though we will provide you with pain medication. We expect you’ll feel discomfort while your incision heals despite your pain medications. A feeling of fatigue is expected as you gradually recover, but most patients report feeling completely normal after two to three months.
- Lifestyle changes – In preparation for liver donation, you may need to make some modifications to your lifestyle. These changes will include abstinence from recreational drugs, tobacco and most importantly alcohol. You won’t be allowed to drink alcohol for a full year after surgery to allow your liver to fully recover. You will also be required to visit the hospital and lab repeatedly, as we’ll need to perform several medical tests prior to surgery. You will gradually be able to return to your normal activities as you recover, although we recommend not participating in contact sports for at least 10-12 weeks postoperatively.
- Complications – These can range from mild to severe and are directly related to the amount of liver tissue removed from the donor.
- There is a 10-35% risk of developing a mild complication, such as an infection. Mild complications are easily treatable within our hospital, and our team will closely monitor you to detect them early. Being under anesthesia also provides its own set of possible complications. We’ll have a team of anesthesiologists present during and after surgery to constantly monitor you.
- There is a 10% risk of developing a serious complication that would require another procedure to treat the complication. You will be closely monitored for signs of complications, and you won’t be discharged until these risks have safely diminished. Serious complications include bleeding or injury to your remaining liver, bile leak or fluid in your abdomen, or a hernia at your incision site. There is a small but real possibility that a liver donor could have a catastrophic complication resulting in the donor dying or needing a liver transplant themselves. This risk is estimated to be between 1/1000 for left lobe donors and 1/200 for right lobe donors.