Liver Transplant Donation Process

Published by Samane Nobakhti at February 17, 2020

Where does the liver used in the transplant come from?

Two types of liver transplant are:

Deceased-donor
Living donor

Liver transplant from deceased-donor

In transplant from a deceased-donor, the donor may be the victim of an accident or brain injury. The donor heart is still beating, but the brain has stopped functioning. Such a person is considered legally dead because the brain activity is permanently stopped without return. At this point, the donor is usually placed in the intensive care unit.

Living-donor liver transplant(LDLT)

Liver transplant from a living donor is an alternative option for some patients who are in the final stages of liver disease. This involves removing part of the liver from a healthy living donor and transferring it to the recipient's body. The donor and recipient liver sections reach normal size within a few weeks due to the ability of the human liver to regenerate .
The donor, who may be a blood relative, spouse, or friend, is subject to extensive medical and psychological assessments to ensure that the risk is as low as possible. Blood type and body size are important factors in determining the appropriate donor. Liver recipients from the living donor must be on the transplant waiting list. Their health also needs to be sufficiently stable to allow the transplant to have a high percentage of success.

Liver Donor Testing

Hospitals evaluate all potential liver donors for evidence of liver disease, alcoholism or drug abuse, cancer, or infection.
Donors are also tested for hepatitis, AIDS, and other infections .If the test does not indicate a problem with the liver, donors and recipients will be matched based on blood group and body size. Age, race, and gender don't matter.
The transplant team will discuss the options available to the patient in a pre-transplant evaluation, or the patient may contact the transplant team for further information.

Identifying liver transplant candidates

The best person to diagnose the necessity of a liver transplant is a gastroenterologist who first monitors the patient and identifies the patient as a candidate for the transplant, considering the age, cause and degree of the disease. The following actions are required before surgery:

Correct tissue diagnosis
Determination of disease level
Patient's mental state
Detailed examination of the patient's general condition (heart, lung, kidney)
Perform biological tests such as ultrasound, CT scan, etc. to determine liver anatomic status
Examination of active infection in the body

Characteristics of liver donor

Once the doctor has determined that the patient is a liver transplant candidate, it is time to select the liver donor. The liver donor must have an accurate assessment of the level of health and blood group and identifying whether the cells surface proteins are similar to the recipient or not. First-degree relatives are the first-line candidates for liver donation to the patient.

Ages 18 to 60 years
Good physical health without physiological diseases and drug use
Not smoking
Ability to understand and follow instructions for preoperative preparation and postoperative recovery
Having a liver the same size or larger than the recipient

Perform complementary tests to ensure that the transplanted liver will not be rejected

Techniques of liver transplantation

Liver transplantation is performed in three ways:

Orthotopic transplantation:
Replacing the patient's liver with a donated healthy liver. It is the most common method.

Heterotopic transplantation (piggyback transplantation) :
The donated liver is located elsewhere ,into an ectopic site and the patient's liver remains intact.

Reduced-size liver transplantation:
Replacing the liver with a portion of the donated liver. This is usually common in children.