One of the key steps in preparation for living donor liver transplant is deciding which portion of the donor liver to remove for transplantation into the recipient. Though there are many factors, this decision is mainly based on the size of the donor liver and the weight of the patient receiving it. The transplant team needs to ensure that at the end of the procedure:

• The donor has enough liver left after surgery to ensure their safety and long-term health.
• The recipient receives a large enough liver to be able to recover and thrive after surgery.

The three main types of live donor liver grafts used for transplantation are:

1. Left lateral section graft (roughly 20 percent of the total liver mass). Usually used for transplants from adults into younger children.
2. Left lobe graft (roughly 30 percent to 35 percent of the total liver mass). Usually used for transplants from adults into older children or smaller sized adults.
3. Right lobe graft (roughly 60 percent to 65 percent of the total liver mass). Usually used for transplants from adults to other similar sized adults.

What Happens During the Living Donor Liver Transplant Procedure?

Donor Operation

• Generally, the donor is taken to the operating room first and goes under general anesthesia.
  Large IV’s are placed to give fluids and medicines during surgery.
• Surgery begins. The type and size of incision made depends on the type of liver graft to be removed.
• The proper anatomy is identified and the liver is split in preparation for transplant into the recipient.
• The liver graft is fully removed from the donor after splitting, prepared for transplant and transported to the recipient room.
• The donor is transported to the ICU for recovery and monitoring.

Recipient Operation

• Once the donor is safely asleep in the operating room and the donor surgery begins, the recipient is taken to the operating room and undergoes general anesthesia.
• Recipient surgery begins.
• The recipient’s old liver is completely removed as the donor’s liver is split in preparation for transplant.
• The donor liver is brought into the recipient room and transplanted.
• The recipient is transported to the ICU for recovery and monitoring.

Donor Resources

There are resources available for eligible living liver donors that can provide reimbursement for non-medical expenses such as travel, lost wages, lodging, meals and dependent care related to the donor evaluation and surgery.  Please contact your living donor coordinator for additional information.

• Donor Shield website
• Introduction to the National Living Donor Assistance Center (video)