There are several phases in the donation process, including evaluation, surgery and recovery. It is important for donors to be aware of the risks associated with liver donation and all that the donation process entails. Your safety throughout the donation process is a paramount goal of our living donor program. You will have a living donor advocate, and your team can even connect you to a transplant mentor—someone who has previously donated and can share their personal experience with you.

Evaluation for a Living Donor

The evaluation helps determine if you are an appropriate match with your recipient and if you are medically fit to donate. In the first stage of evaluation, you’ll complete a liver donor questionnaire and informed consent form, and have a telephone interview with your independent living donor advocate.  Next, the team will proceed with donor testing.

Comprehensive testing may include, but is not limited to, the following:

• Laboratory blood tests
• Urine test
• CT abdomen/pelvis with IV contrast
• MRI/MRCP abdomen without contrast
• Chest X-ray
• Echocardiogram
• EKG

Depending on your health history, you may be required to complete a cardiac stress test or other testing.

You will need to be up to date on age related health screenings:

• Pap smear
• Mammogram (for women over age 40)
• Colonoscopy (if over age 50, or sooner if increased risk)

It is recommended that living donors have a primary care provider. The team may recommend or require follow-up by your primary care provider of any abnormal findings.

If these studies are satisfactory, you’ll next meet with the live donor team during a multidisciplinary clinic appointment to discuss the procedure and its risks. The physicians and surgeons will review your test results and health history. During this time, you will also be evaluated by a social worker, dietician, donor advocate and nurse coordinator. You may also be evaluated by a psychiatrist, pharmacist or other providers as needed. Further testing or consultation may be required based on the findings of your evaluation.

Once the work-up is completed, your case will be presented to the multidisciplinary live donor transplant team. This team includes surgeons, hepatologists, psychologists, donor advocates, dieticians, pharmacists, social workers and nurse coordinators. They represent you and make decisions that are in your best interest regarding donation.

It is important to note that, as a donor, you will have a different transplant team from your recipient. Your team cares for you exclusively. At the Johns Hopkins Comprehensive Transplant Center, organ donors are given the same considerations and respect as all of our patients.

Note: At any time during the evaluation process, up until the very moment of surgery, you are entitled to change your mind about the donation. This decision is made with your physicians and is kept completely confidential.

Surgery and Recovery for a Living Donor

After a thorough evaluation, if you are approved for donation, surgery will be scheduled. Unless an urgent transplant is needed, surgery is usually scheduled four to six weeks in advance. Typically, a liver donor spends approximately five to seven days in the hospital, and will have an additional six to eight weeks of recovery time. Donors who are from out of town (greater than a two-hour drive) should plan on spending an extra two to three weeks in town after they are discharged from the hospital. The team will assess at your post-op visit when it is safe for you to return home.

During the early recovery period, you will experience some pain and discomfort from your incision, which is usually well controlled with pain medications. You are monitored very closely early after surgery for all the appropriate signs of recovery and liver regeneration. Once your pain is well controlled, you are eating and drinking well and you are up and walking around without too much difficulty, you are discharged from the hospital.

After discharge, you are advised not to lift anything heavier than 10 pounds for at least six weeks. You are instructed not to drive while on sedating medications and fatigued, which is at least two to three weeks after discharge. You are encouraged to walk several times a day. If you have small children, you may need initial help in caring for them. Depending on the type of work you do, you may be able to return to work six to eight weeks after surgery. Your liver will begin to regenerate immediately after surgery and will be back to normal size in six to eight weeks. Your recovery after discharge will be closely monitored with routine clinic visits and laboratory tests.

If you are interested in becoming a living donor, call 410-614-2989 or complete an online questionnaire.

Risks Associated with Liver Donation

Even though live liver donation is considered a very safe operation, it involves major surgery and is associated with complications, which may include:

• Possible allergic reaction to anesthesia
• Pain and discomfort
• Nausea
• Wound infection
• Bleeding that may require transfusion
• Blood clots
• Pneumonia
• Bile leakage, bile duct problems
• Hernia
• Scar tissue formation

In rare instances liver failure, which may require transplantation, and death may occur.