2. Donation Pros and Cons

Gift of Life

By choosing to become a donor, you’re giving the priceless gift of life to a loved one. By being their living donor, you’re shortening the time they spend in sickness while waiting for a liver, while increasing their time living a healthy life. At the same time, you’re increasing the likelihood of a successful transplantation, since survival rates are higher when the graft comes from a living donor. Additionally, you’ll be helping another wait-listed patient, since you’ll be opening the 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. Through a process known as compensatory growth, the remaining portion of the liver will enlarge itself to make up for the body’s functional demand. As little as 25% of your liver can regrow itself to its original size. After donation, liver function returns to normal in 4-6 weeks, and your liver will slowly regrow to its full original size in about a year. This regenerative property is the essence of live donor adult liver transplant.

Low Financial Burden

The entire donation process is typically paid for by the insurance company of the recipient. This includes all evaluations, the surgery, in-hospital recovery and follow-up care. This can be of great relief to you, as it removes any financial limitations that you might have had otherwise. Some items, such as painkillers, may not be covered by the recipient’s insurance company, so our financial coordinator will identify how to cover them.

Time Commitment

Liver donation is an invasive surgery that will take time and personal effort to recover from. The evaluation process is a necessary and time-consuming process that will take you away from other activities. Your hospital stay will last from 4 to 6 days, but you won’t be able to return to work or school until 6-12 weeks after hospital discharge.

Pain

Pain is, unfortunately, inevitable with a surgery of this magnitude, despite the pain medications we’ll provide you. We expect you'll feel discomfort while your incisions heal, despite the painkillers we'll provide you. A feeling of fatigue is expected as you gradually recover, but most patients report feeling completely normal after three months.

Lifestyle Changes

In preparation for liver donation, you will 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.

Mild Complications

Due to the invasive nature of the liver donation surgery, there is a 35% risk of developing a mild complication. These are easily treatable within our clinic, and our team will closely monitor you to detect them early. These complications may include:

• Wound infection
• Urinary tract infection
• Temporary nerve injury
• Skin breakdown

• Lung infection from lack of coughing reflexes while asleep
• Blood clot in veins or lungs, from reduced mobility while laying still for many hours
• Pneumonia
• Heart complications, such as irregular heartbeat or blood pressure changes.

Serious Complications

The risk of developing a complication that would require an emergency procedure (such as re-operation) ranges from 10%-15%. You will be closely monitored for signs, and won’t be discharged from the hospital until these risks have safely diminished. Bleeding is a large concern because the liver has many vessels going through it. These complications may include:

• Bleeding or injury to remaining liver
• Bile leak or other abdominal collection of fluids
• Incisional hernia
• The possibility of needing a transplant yourself.

Possible Death (Mortality)

The complications mentioned above may result in the donor passing away. There is a 0.5% risk of death (1 in 200), as reported by the Scientific Registry of Transplant Recipients (SRTR) 2010 annual report. Only four living liver donors have passed away in the U.S. from surgery-related complications since 1999.