Living Donor Liver Transplantation

IMG_0286What is Living Donor Liver Transplantation? Living donor liver transplantation is one of the ways in which a liver transplantation is performed, the other being deceased donor liver transplantation. In a living donor liver transplantation a healthy donor donates a part of his/her liver which is then transplanted into the recipient who needs a liver transplant.

There is just one Liver in my body, how can I donate it? Yes liver is an unpaired organ unlike the kidney which makes people wonder how a liver can be donated. The answer to this question lies in the unique ability of the liver to regenerate, which means that when a part of a person’s liver is removed for any reason, the remaining liver grows back to compensate for the part which has been removed. This unique ability of the liver underlies the principal of living donor liver transplantation where the remaining liver grows back in the donor and the transplanted liver grows to normal size in the recipient’s body. 

How much of my liver is removed when I decide to donate it for someone? How much liver is removed from a liver donor is a complex calculation and it depends on a lot of factors like is the donation for an adult or a child, what is the weight of the recipient in proportion to your weight , the structural complexity of your liver etc. On an average approximately 30-35% of the liver is removed when donating for a child and 60-65% when the donation is for an adult recipient.

 Is it safe to remove 65% of my liver? According to extensive research and experience of thousands on liver surgeries, specialists around the world believe that 20-25% of normal liver is enough to sustain a person in good health while the liver re-grows to its normal size. A lot of times when we are doing liver surgeries for patients with liver cancer and other liver diseases we remove almost 75-80% of the diseased liver and the patients recover without any problems. Therefore the removal of a part of the liver for donation is safe as per decades of research from around the world. 

What are the risks involved in Liver donation surgery? Liver donation is a major and complex surgical undertaking which is carried out only in a handful of specialised hospitals around the world, meticulous planning goes into the execution of the surgery and the safety of the liver donor is of paramount concern for hospitals performing this operation. However in spite of the diligent planning, complications resulting from theoperation can happen in about 5% of donors undergoing this operation. Most of these complications are however minor in nature, only about 1-2% people can develop serious and life threatening complications arising from the donation.

Which is better Deceased donor or Living donor Liver transplantation- As far as the medical results of transplantation are concerned the results of both types of transplants are equal. Which type of transplantation is better for you will depend on a lot of factors like how advanced your liver disease is, is the transplant needed in an emergency, which part of the world or India do you want to have the transplant, which city do you stay in, what is your family and social structure etc. The decision for which type of transplant is best for you is best taken in consultation with your transplant surgeon.

 

 

The author Dr. Abhishek Yadav is a senior consultant liver surgeon and director of comprehensive liver care institute at VPS Lakeshore hospital Kochi