In the case of living liver donation, a part of the liver is transplanted. The remaining piece of liver remains in the donor’s body and grows almost back to its original size after donation. The removed liver section is transferred to the recipient and takes over the functions of the diseased liver.
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Living liver donation – facts and figures
At the end of 2020, there were 891 people on the waiting list for a liver transplant in Germany. 826 livers were transplanted in 2020. 52 of these donor livers came from a living organ donation. This means that for every 100 livers transplanted, about six come from a living organ donation.
In this procedure, a part of the liver is removed from the donor. The liver section is then transplanted.
Procedure for living liver donation
The process of living organ donation begins long before the actual removal operation. Before the actual transplantation, the prerequisites must be clarified. Then the removal operation and transplantation take place. The time after the transplantation is characterized by follow-up examinations.
Before the transplant
- The recipient must be on the waiting list for a postmortem donated liver.
- The donor must meet all requirements for living organ donation.
- Before the liver section is removed, the condition of the organ is medically checked.
- Individual psychological interviews are held to clarify the motivation of the donor and the recipient.
- The living donor committee of the hospital prepares a recommendation for living organ donation.
- Immediately after the part of the liver is removed, it is transferred to the recipient.
- The removal operation and the transplantation to the recipient take place at about the same time and in the same hospital.
After the transplant
- After the transplant, the donor usually stays in the hospital for one to two weeks.
- Both go to medical follow-up examinations at regular intervals.
As a general rule, the donor must be in good health. Liver, heart and vessels should function normally. High blood pressure and abnormal blood sugar levels are reasons for not donating.
For living liver donation, the age limit is between 18 and 60 years of age.
Risks of living liver donation for the donor
As with any surgery, complications can occur with living liver donation. These mainly include:
- Wound healing disorders and temperature increases,
- temporary liver failure,
- Death (necrosis) of the liver tissue at the interface,
- Inflammation of the biliary system,
- Injury of the bile ducts (bile leak).
In living liver donation, only part of the liver tissue is transplanted
Only enough liver tissue is removed so that the transplantation has a high chance of success. At the same time, so much liver tissue remains with the donor that no permanent impairment of health is to be expected.
The protection of the person donating the tissue is always paramount. In adult donors, about 60 percent of the liver is removed. A portion of the slightly smaller left lobe of the liver is often transferred to children. The entire left lobe of the liver is transferred to adolescents and the right lobe to adults.
The ratio of the liver tissue to be transplanted and the body weight of the recipient is important. For a recipient with a body weight of 70 kilograms, the transplant should weigh at least 700 grams. For this reason, the donor should not be significantly smaller or lighter than the recipient.
After donation, the remaining liver grows back almost to initial size. The same also applies to the transplanted liver section.