Because the liver contains blood vessels, bile ducts and other structures, transplant surgeons use detailed, three-dimensional images to create a kind of roadmap for living donor surgery.
No transplantation surgery is easy, but removing a piece of liver from a living donor and transplanting it into a critically ill adult or child is particularly complicated.
The first step is for potential donors to overcome misconceptions about liver disease. “Many people think alcohol and drug abuse cause liver disease, but there are actually many different causes,” said Annmarie Liapakis, MD, Yale New Haven Transplantation Center (YNHTC) transplant hepatologist.
Viral infections, immune disorders, genetic conditions, fatty liver disease and heart and vascular disease can cause hepatitis (liver inflammation). Hepatitis can cause scarring (fibrosis); severe scarring is called cirrhosis. Cirrhosis can lead to liver dysfunction, cancer, portal hypertension – high blood pressure around the liver – or a combination.
YNHTC offers comprehensive services to treat and manage liver disease before and after transplant. Surgeons perform deceased and living donor transplants, transplants between HIV-positive people and adult-to-child transplants.
Donors and recipients do not have to be related. Through Yale New Haven Hospital’s Center for Living Organ Donors, potential liver and kidney donors undergo an extensive process that includes counseling and a thorough medical evaluation. A Donor Advocacy Panel of healthcare professionals determines if the person is eligible to donate, and a donor advocate supports the potential donor during the review process.
Once a liver donor and recipient are matched, surgeons plan in detail what will occur in the operating room. With a deceased donor, surgeons can remove the entire liver and other structures, (though they will sometimes divide the liver so two recipients can benefit). With living donors, radiologists and transplantation surgeons use advanced, three-dimensional imaging to determine precisely which part of the donor liver they will remove and how they’ll divide the tangle of veins, arteries and bile ducts between donor and recipient.
On average, a liver donor will have a five- to seven-day hospital stay and recovery that includes no heavy lifting for six to eight weeks. By that time, barring complications, the donor’s and recipient’s livers will regrow to full size.
“Liver disease takes such a physical and emotional toll on patients and their loved ones,” Dr. Liapakis said. “But as long as we have organ donors, there is hope. Organ donors are true heroes.”
To learn more about becoming a liver donor, visit the Center for Living Organ Donors or call 866-925 3897.
