Living Donor Liver Transplant Program

A living donor liver transplantation is a surgery that removes a diseased or malfunctioning liver and replaces it with a portion of a healthy liver from a living donor. Liver regeneration allows the partial livers of the donor and the recipient to grow into complete organs. It truly is the gift of life and offers several benefits:

Shorter wait times: If you have a living donor, you don’t have to wait as long, even if you have a low model for end-stage liver disease score. A shorter wait time can reduce the risk of death while waiting on the deceased donor list. Use this waiting list outcome tool to help calculate your potential wait time.

Faster recovery: Living donor recipients experience shorter hospital stays and are less likely to require blood transfusions or dialysis after surgery.

Improved outcomes: According to the Organ Procurement and Transplantation Network, recipients of living donor livers have an average of five percent better long-term survival rates than recipients of deceased donor livers.

If you’d like to be contacted about this program, fill out the Living Liver Donor contact form, call us at 504-842-3925 or email us at LivingLiverTrans@ochsner.org.

The Ochsner Transplant Institute is here to support our potential and current living liver donors. If you’re considering becoming a living donor, it’s important to learn as much as you can. Our number one priority in living donation is the health and safety of the donor. The careful evaluation process is designed to ensure appropriate selection of donors and a safe surgery for both the donor and recipient.

Being a living donor doesn’t mean you won’t have a complete liver. In fact, liver regeneration allows the partial liver of the donor to regrow into a complete organ. In approximately three months, the remaining part of your liver will grow back to its normal size. Even on the day of surgery, the remaining volume of liver is enough for normal function.

Who can become a living liver donor?

A living donor does not need to be related to the recipient to donate. The Ochsner living donor transplant team understands that every transplant is different and is here to provide support every step of the way. Restoring health to a close friend or family member needing a new liver is a priceless gift.

Requirements of becoming a living donor

A healthy donor must:

• Be between the ages of 18 and 50
• Be in good physical and mental health
• Have a body mass index (BMI) less than or equal to 32
  • For patients with a BMI over 32 and who are otherwise healthy, we can work with the patient to become a potentially suitable candidate.
• Not engage in active ongoing drug or substance use
• Have an unselfish desire to contribute to another person’s life in a healthy way
• Be in general good health with no history of:
  • Liver disease, including cirrhosis and hepatitis
  • Significant diseases involving the other organs: lung, kidney, and heart
  • Pulmonary hypertension
  • Human immunodeficiency virus (HIV)
  • Active malignant cancers
• Have a compatible blood type

How can I become a living liver donor?

The living donor transplant team understands that every transplant is different, and they will be there with you every step of the way. We recommend you speak to your primary care physician, family, friends and the transplant candidate about becoming a living donor.

• The interview
  • Fill out the online form or contact us at 504-842-3925 or LivingLiverTrans@ochsner.org. Once you contact us, we will start the interview process.
  • Your information and medical history will be gathered over the phone. Your information and medical history will remain confidential and will be reviewed before proceeding with the next step of evaluation to avoid any unnecessary testing.
• The evaluation: what can I expect?
  • Exams:
    • Medical evaluation with a hepatologist, surgeon and internal medicine physicians
    • A psychosocial/psychological evaluation
    • Meeting with donor advocate (separate from the medical team)
    • Imaging with CT scan and MRI
    • Age-appropriate cancer screening (mammogram, colonoscopy, pap smear, etc)

These tests are to make sure you are healthy and that your liver function is normal or near normal. Once we review your test results, we will decide if you can donate.

• Three: the surgery
  • Extensive preparations go into planning every detail of the donor and recipient surgeries.
  • When the donor and recipient evaluations are complete, the surgeries can be scheduled.

The insurance of the person needing the liver transplant pays for the donor’s:

• Testing
• Surgery
• Hospital stay
• Medical visits for the first month after surgery

*Note: Travel and time off from work are not paid for by insurance. *

Your living donor advocate

We will assign an independent living donor advocate who will act on your behalf. Your living donor advocate will:

• Make sure you are fully aware of what it means to be a living-liver donor
• Answer any questions on how to donate your liver
• Explain and help you understand the benefits and risks
• Voice any of your concerns to the liver transplant team

How to prepare for your living donation

If you are approved as a living donor, you will work with the transplant team to schedule a date for your transplant. Once the surgery is scheduled, you and your recipient will come for an appointment the day before surgery. You and your recipient will meet in the same room, at the same time, along with your family or loved ones. This appointment will last about one to two hours.

The transplant surgeon will:

• Review the process of the surgery
• Get consent forms signed
• Give instructions about when to stop eating and drinking before surgery
• Answer any last-minute questions

Once this appointment is over, you will leave and will come back to be admitted early in the morning on the day of surgery.

Liver surgery for living donors

Living donor liver surgery may differ depending on if the recipient is a child or an adult. Donation to a child involves the removal of the smaller left lobe of the liver while donating to an adult usually requires the removal of a portion of the larger right lobe.

How long Is living donor liver surgery?

The entire living liver donor surgery will take five to seven hours.

The surgery requires general anesthesia and abdominal incision. During the operation, the liver is freed up and the major blood vessels supplying the liver lobes are isolated. The liver tissue is then carefully split into two pieces. After the liver is divided, the blood vessels to the portion of the liver being donated are clamp and cut. The piece of liver is removed and transferred to the recipient operating room for transplant. After careful inspection for bleeding, the incision is closed with dissolving sutures and skin glue.

Each incision varies on the size of the abdomen and the lobe removed. Our surgical team works hard to keep the size of the incision to a minimum. It’s important to follow instructions after donation and care for your incision properly to promote healing and minimize the scar. Limit activity and lifting heavy objects to avoid a hernia.

The recovery process

After donation, Ochsner closely monitors all patients. We take pride in creating an environment that supports the needs of our patients and their families. The donor typically remains in the hospital for four to seven days after surgery. On the first night, the donor will stay in the Surgical Intensive Care Unit (SICU). Typically, on post-operative day 1 or 2, the donor can be transferred to the transplant step-down unit where our nurses specialize in the care of transplant donors and recipients. Total length of hospital stay will vary. Donors can be considered for discharge when pain is well controlled with oral medications, able to ambulate with minimal assistance and tolerating a regular diet.

Donors recover approximately three to six weeks after surgery. This time varies per donor. During this period, donors will return to the hospital for routine visits. Our physicians will monitor and assess their heath and let the donor know when they can resume normal activities.

What healthcare costs does the donor incur?

The recipient’s health insurance will cover the donor’s medical expenses. This includes:

• Donor evaluation (if performed by the Center for Liver Disease and Transplantation)

• Surgery

• Hospitalization

If more financial assistance is needed, contact the Health Resources and Services Administration (HRSA). The HRSA created a program known as the National Living Donor Assistance Center. This program helps cover all travel, lodging, meals, and incidental expenses incurred by the donor as part of:

• Donor evaluation

• Hospitalization

• Medical or surgical follow up (within 90 days of the procedure)

The program will pay for a total of up to five trips, three for the donor and two for accompanying persons. The accompanying persons need not be the same each trip.

Visit the National Living Donor Assistance Center’s website to learn more.

Why is living organ donation important?

Did you know? Living donation accounts for almost 6,000 organ donations every year. To receive a living donation, reduces a person’s wait time on the waitlist. This time is vital to saving lives. A liver from a living donor can also start functioning immediately, leading to better results overall after surgery.

Our transplant team will discuss, in detail, the benefits and risks of living-liver donation during your evaluation. If you feel uneasy, we can stop the process at any time.

What are the benefits of living donor liver transplant?

There are several benefits to becoming a living liver donor. Donating saves lives!

• Shorter wait times: If you have a living donor, you don’t have to wait as long, even if you have a low MELD score. A shorter wait time can reduce the risk of death while waiting on the deceased donor list. Use this waiting list outcome tool to help calculate your potential wait time.

• Faster recovery: Living donor recipients experience shorter hospital stays and are less likely to require blood transfusions or dialysis after surgery.

• Improved outcomes: According to the Organ Procurement and Transplantation Network, recipients of living donor livers have an average of five percent better long-term survival rates than recipients of deceased donor livers.

What are the risks of living donor liver transplant?

Our living donor transplant team will discuss all possible risks with you before the procedure – donor safety is our top priority. As with any major surgery, living donor liver transplantations come with risks, including possible complications. For donors, these include:

• Bile duct leakage

• Bleeding

• Blood clots

• Hernia

• Infection

• Nausea

For recipients, the risks are like those of a deceased donor liver transplantation. These include:

• Bile duct leakage or shrinkage

• Bleeding

• Blood clots

• Failure of donated liver

• Infection

• Mental confusion or seizures

• Rejection of donated liver

However, because the donated liver comes from a living donor, serious complications occur at a lower rate. Research has shown little long-term risk or effect on a living-liver donor. Death is extremely rare but has occurred in a few cases.