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About Living Donor Liver Transplant

Living liver transplant surgery is a lifesaving option for patients with end-stage liver disease, as it provides a faster path to transplantation compared to waiting for a deceased donor liver transplant. Through living donation, a person can donate a portion of their liver to someone in need of a liver transplant. This patient can either be someone the donor knows personally, or donations can be made altruistically to an unknown recipient. Both the donor’s liver and the recipient’s liver grow back to full size within a few weeks — in fact, the liver is the only organ in the body that is capable of regenerating itself.

What Are the Benefits of Living Liver Donation?

There are more than 11,000 Americans currently on the waitlist for a deceased donor liver. Deceased donor livers are in short supply and are only allocated to the sickest patients at the top of the waitlist. Every year, nearly 20% of patients awaiting a liver transplant in the United States die or become too sick for the transplant.

There are many benefits to living liver donation for both the recipient and the donor, including:

  • It is faster than waiting for a liver from the organ waitlist
  • The recipient avoids health complications that can arise while waiting for a transplant
  • A liver from a living donor also has a longer survival rate
  • A living donor liver is often healthier than a deceased one
  • The liver will begin to fully function for the recipient immediately after living donor surgery
  • The donor and the recipient can pick the surgery date that works best for their schedules

What to Expect at Mass General

One of the Most Experienced Centers for Living Liver Donation and Liver Transplant

The Mass General Brigham Liver Transplant Program has one of the most experienced living donor programs for liver transplant in New England. Living donor liver transplant is a complex surgery for both the donor and the recipient, so it’s critical to receive care from a high-volume transplant center.

When pursuing living liver donation at Mass General Brigham, donors can expect to:

  • Receive high-quality, integrated care at every part of the health journey
  • Work with a multidisciplinary and highly specialized care team that are leaders in their field
  • Benefit from leading edge research being pioneered by our world-class physician-scientists (e.g., improving outcomes and tolerance following organ transplantation) — these researchers are the same doctors who will be providing your care

The Process to Become a Living Liver Donor

A male liver donor sits next to his sister, the donor recipient, on a couch.

In 2009, Steve, right, became a living liver donor for his sister, Nicola, left, at Massachusetts General Hospital.

Donor safety is our top priority and central to our process. In order to effectively plan for liver transplant surgery and secure the best possible outcomes for both the donor and the recipient, living donors can expect a thorough evaluation and screening process with the Mass General Brigham living donor liver transplant team. This is to ensure the safety and wellbeing of every donor and recipient who undergo living donor surgery.

We know that donors are taking time out of their personal lives to help their loved ones. We are committed to providing the highest quality of care while also striving to complete evaluation in a timely manner (within two weeks).

Donors may choose to discontinue their evaluation and participation in the program at any point in the process, for any reason, with complete confidentiality.

Submit interest and undergo an initial health assessment

The first step is for prospective donors to contact our team to express their interest in becoming a living liver donor. Donors can either call our living donor team at 617-643-5202 or fill out our secure online form. Once contact has been established, our living donor nurse coordinator will contact the prospective donor to describe the process, gather additional information about their medical history and obtain consent for evaluation.

If the donor meets the criteria for donation, they will be scheduled to meet with the independent living donor advocate who will explain the evaluation and donation process and evaluate the donor’s motivation and capacity for informed consent.

If the donor decides to proceed after the initial evaluation, they will be scheduled for evaluation and standard blood testing to determine blood type, liver function and overall health status. Blood testing and evaluation can be performed at Mass General, Brigham and Women’s Hospital or at another Mass General Brigham community location.

Meet with the living donor liver transplant team

Next, donors will meet with the living donor team — which consists of an independent liver advocate, nurse coordinator, social worker, nutritionist, psychiatrist and financial coordinator — to learn more about the donation process and go over any questions.

During this meeting, the team will:

  • Ensure the donor is fully informed on what it means to be a living liver donor, including the process, risks and benefits
  • Answer all questions
  • Go over any concerns

During this meeting, prospective donors will also undergo a comprehensive evaluation with the team, which will include:

  • A complete medical history and physical examination
  • Additional testing such as an electrocardiogram (EKG), chest X-ray and a CT scan and MRI, and cardiac stress test
  • Additional blood work or tests, as needed

Once the medical and laboratory tests are completed, donors will meet with the liver transplant surgeon, liver transplant hepatologist and infectious disease specialist for comprehensive medical and surgical evaluation and to discuss risks, benefits and what to expect for surgery and recovery.

If there are no barriers to donation, donors will undergo a liver biopsy and any additional testing or consultations as determined by the team.

Determine eligibility and schedule surgery

Once all testing and evaluations are complete, the transplant team will determine the donor’s eligibility to become a living liver donor. Once approved, they will schedule the surgery on a date that is convenient for both the donor and the intended recipient. This allows both parties to make arrangements such as time away from work, childcare, etc.

Frequently Asked Questions: Living Liver Donor

How do I become a living donor?

Please call the Mass General Brigham Liver Transplant team at 617-643-5202 or complete our online form to begin the living donor evaluation process.

Do I need to be related to the recipient to become a living liver donor?

No, donors and recipients do not need to be related to undergo living liver transplant surgery. However, they must both meet certain eligibility requirements.

How is the living donor liver surgery performed?

Naturally, a liver has a right lobe and a left lobe. During living donor liver surgery, the surgeons split the liver into two independently functioning lobes. Either the right lobe or the left lobe of the liver is then removed and transplanted into a recipient whose own liver is no longer working properly.

The living donor's remaining liver lobe regrows to its normal size, volume and capacity within a couple of months after the living donor liver surgery. At the same time, the portion of the liver that was transplanted into the recipient also grows and restores normal, healthy liver function.

Can I be a living donor?

Donors must be between the ages of 18 and 55 and have no serious medical problems. All people who volunteer to become living liver donors at Mass General Brigham undergo an extensive evaluation to ensure that they meet the requirements to donate safely. There are many factors that go into this evaluation.

The living liver donor evaluation begins when you call our living donor team at 617-643-5202 or complete our secure online form. A member of our living donor team will contact you to learn more about your health history and schedule a convenient time for you to undergo evaluation to determine if you are eligible to become a living donor.

How long is the process?

The evaluation process takes approximately two weeks and requires three in-person visits to the Transplant Center at Mass General, Brigham and Women’s Hospital or another Mass General Brigham community location. The surgery is scheduled at the convenience of the donor and recipient. Following surgery, donors stay in the hospital for about five to seven days to recover under the care of our team. After discharge from the hospital, donors can expect a one-to-three-month recovery period.

Can I still live a healthy life after donating my liver?

The liver has the ability to regenerate (regrow) — in fact, it is the only organ in the body that is able to do so! A healthy liver grows back to its full size and restores full function within a few months following living donor surgery. The same is true for the recipient once the segment of the liver is transplanted.

Do I need to change anything in my lifestyle to become a living donor?

Living liver donors must be in good physical and mental health in order to donate a portion of their liver. An important change that will need to be made in advance of living liver donation is to abstain from tobacco and alcohol before surgery and for at least six months after surgery.

Donors can typically return to their normal activities a few months after surgery. To allow time for the body to heal properly, donors are discouraged from strenuous physical activities for several weeks. Your doctor will provide information about what to expect for recovery.

Are there any risks or complications associated with donating a portion of my liver?

As with any major surgery, there are risks associated with the living liver donor operation. Our donor’s safety is our top priority. The Mass General Brigham’s liver transplant team’s thorough living donor liver evaluation and testing process helps to minimize risks, as they are considered very carefully during the process in relation to the whole health of the donor. The team works hard to ensure the best possible outcomes for donors and recipients. Most donors can return to their normal activities within a few months after surgery.

Throughout the evaluation process and prior to surgery, our team will discuss all of the possible risks with you and answer any questions that you may have about the safety of the procedure.

Will the donor process cost a lot of money?

The recipient’s health insurance will cover the donor’s medical expenses. This includes:

  • Donor evaluation
  • Surgery
  • Hospitalization for recovery

However, certain costs are usually not covered by insurance or the hospital. These include travel, lodging, loss of income (from time off of work) and other related expenses.

If eligible, some donors may apply for additional financial assistance provided by the National Living Donor Assistance Center. This program will cover all travel, lodging, meals and incidental expenses incurred by the donor such as medical or surgical follow-up (within 90 days after the procedure).

Our team will help you to apply to this program.

What can I expect after living donor transplant surgery?

Following liver donation, our care team will monitor you closely to ensure that you are healing and recovering well. You can expect to be discharged from the hospital after you have returned to eating and walking without difficulty. Once you’ve returned home, you will continue to receive follow-up care from our living liver donor team for a period of time.



Patient Videos

A Brother's Love

Meet Nicola and Steve, a brother and sister with an inspiring story. With the help of Massachusetts General’s Living Liver Donor program, Steve gave the gift of life and a happy future to his sister, Nicola.