Approximately 20% of patients waiting for a liver transplant die or become too sick before they can get one. For the family and friends of those with advanced liver disease, the shortage of available livers from deceased donors is truly heartbreaking.
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Thanks to living liver donation, however, more people have the opportunity to live longer and better than ever before.
“It’s very difficult to watch your loved one suffer from advanced liver disease and continue to take medications to control symptoms without finding real relief,” notes Koji Hashimoto, MD, PhD, Director of Living Donor Liver Transplantation at Cleveland Clinic. “If you’re healthy enough to donate, you have the opportunity to change someone’s life completely.”
Dr. Hashimoto explains how living liver donation works, what’s involved in the recovery process and how a new laparoscopic technique will benefit living donors.
Can I donate part of my liver?
The liver is the only organ in the body that can grow back if a part of it is removed. When a portion of the liver is surgically removed and is transplanted into a recipient, both portions (the one left in the donor’s body and the one transplanted in the recipient) will grow back in six to eight weeks. Liver function returns even faster, within just one week after living donation.
In adults, one of the following lobes are required for liver donation:
- Right lobe: 60 to 70% of the whole liver
- Left lobe: 30 to 40% of the whole liver
Lobe selection depends on the needs of the recipient and the anatomy of the donor liver.
Most small children in need of a liver transplant require only 15 to 25% of a whole liver (left lateral segment).
How do I qualify to donate?
All living donors must complete a qualifying phone interview followed by a complete in-person donor evaluation, which includes blood tests and medical imaging. In general, candidates must:
- Be between 18 and 55 years of age. When donating to a child, donor age can be up to 60 years.
- Be strong enough for surgery and recovery.
- Be free from pre-existing medical conditions, especially those involving bleeding or clotting.
- Not use recreational drugs. Smoking doesn’t disqualify a donor, but ideally, the donor should quit smoking as soon as possible.
- Fully understand the psychological impact of organ donation and its possible risks. For example, the donor must be able to handle the negative emotions that may occur in the event that the donated liver fails in the recipient.
What’s involved in the recovery process?
Living liver donation surgery generally requires a five- to seven-day hospital stay. If there are complications, a longer stay may be needed. There may be limits placed on certain daily and work-related activities after living donation. Donors may return to daily activities in four to six weeks. Work-related activities may be resumed in two to three months. Once fully recovered, donors can return to normal activities.
Donors feel pain associated with the procedure. For some, there may be vague discomfort at the incision site. In 2019, Cleveland Clinic plans to offer a laparoscopic technique that will involve a much smaller incision and less pain during recovery.