Donating a part of your organ can be scary but living liver donation is safe, say experts, as the liver is the only organ in the human body with regenerative tissues. After the liver transplant surgery, both the donor and the recipient can expect their livers to grow back to their normal healthy size within a few weeks.
Living liver donation could be a lifesaver for millions of people with end-stage liver disease as finding a deceased donor with matching liver tissue could be extremely time-consuming and tiring.
Dr Chetan Kalal, program director, hepatology and transplant medicine, Nanavati Max Hospital, Mumbai, says that any healthy individual can donate their liver. Even people who have diabetes, thyroid issues or blood pressure under control could be considered for liver donation after a thorough investigation.
Prof Dr Tom Cherian, senior liver specialist and transplant surgeon, Manipal Hospitals, Vijayawada, and the Founder of South Asian Liver Institute, notes that the donor’s cardiovascular fitness matters before the surgery. They should be physically active and should engage in jogging, cycling or climbing stairs for a month or so before the transplant. “Apart from that, a good diet that is not high in carbohydrates and includes fresh vegetables and fruits and moderate amounts of protein should be consumed. These are the rules of thumb for all living liver donors,” he says.
Liver donation requirements
The interested candidate is thoroughly examined. If the donor is fitting the criteria, several tests are conducted in different phases to check the liver health and overall fitness of the individual.
Dr Kalal says that in phase one, routine tests for CBC (complete blood count), renal function, liver function, diabetes and thyroid are done. “If the potential donor is a woman in the reproductive age group, then we do urine tests for pregnancy also. If we think the profile is normal, the donor is subjected to the second phase where we do more liver-specific tests. We do liver attenuation index, which is a CT scan to quantify fat in the liver. If the liver is healthy and if there is no fat or a certain amount of fat, we can consider taking the process ahead,” he explains. The volume of the liver is calculated, and the ductal anatomy is detailed. This is followed up by an operative fitness workup that includes cardiac, lung and psychological fitness.
He says physical fitness is very important as a liver transplant is a major operation. “If you meet all the other criteria but your heart or lungs are not fit to undergo the operation, you can’t be a candidate,” he adds.
Liver transplant surgery
One needs 20 per cent of the liver to live. Dr Kalal says the liver has two lobes – the right lobe is 60 per cent and the left is 40 per cent. “If the donor is ideal after the thorough assessment, we take 60 per cent of the donor’s liver to transplant into the recipient. The recipient’s old liver is removed 100 per cent. In the donor, we keep approximately 40 per cent, which is almost double than what is required,” he says.
Dr Cherian adds that usually, the liver transplant surgery can take about seven to eight hours.
Does donating part of your liver shorten your life?
Experts say that donating part of the liver does not shorten the donor’s life and the liver in both the donor and the recipient will grow to 100 per cent of its size within three months.
Dr Kalal points out that more than 50 per cent growth will happen within two weeks of the transplant.
Dr Cherian adds that the time taken for the growth does not depend on the amount of liver removed for donation.
Risks and complications for the donor
Experts say the donor’s safety is given utmost priority and they can back out at any point in time. They assure not to reveal the reasons behind the donor’s change of mind to the families.
The success rate of the surgery is over 99 per cent. Dr Cherian says there are no major risks for the liver donor. Compared to other surgeries, the risks are much less. “There could be a small chance for blood or wound infections or complications related to anesthesia,” he says.
The donor usually gets discharged within six to eight days of the transplant surgery. Dr Kalal explains, “Most donors are extubated on the table at the end of surgery and are transferred to the ICU where they are observed for two days. On the third day, they are shifted to the ward for four to five days.” By the sixth or seventh day, they get out of the hospital.
Recovery
The recovery after liver donation is also simple. The donor is prescribed certain medications for two to three weeks and asked to visit the hospital for follow-ups twice. They are asked to undergo basic tests to check their hemoglobin levels and liver function.
Dr Cherian says, “Within four weeks, they can go back to their job and start leading a regular life. They are given clear instructions as to what they need to do and what they shouldn’t do. They should maintain a good healthy diet and start with light exercises. They can start with just breathing exercises, followed by walking. They should avoid heavy weightlifting for about six weeks.”
Dr Kalal adds, “After six weeks, once their scar is healed, they can do anything. I have had donors who have participated in full marathons and even won them and also women who have conceived after liver donation. So, one’s professional, personal, married and sexual lives don’t get affected by donation.”
