Liver for transplant can be obtained from two types of donors.

Cadaveric donation

Such donation is possible from a brain dead person whose family wishes to donate the person's organs before discontinuing life support. This situation arises only in a hospital ICU in a person after brain injury in an accident or in someone who has suffered fatal brain hemorrhage etc. In these circumstances, the whole liver can be used for an adult, and a part of it for a child. After removal from the donor (a process called liver retrieval) the liver can safely be kept preserved outside the body in special preservation solutions for 12-15 hours.

Allocation of such organs is strictly according to blood group which must match, time on waiting list and urgency of requirement.

Living liver donation

Liver donation is also possible from a living donor who is a relative of the recipient who can donate half his/her liver. The donor operation is entirely safe and the half liver quickly regenerates in both the donor and the recipient in a few weeks. In the first few days after operation even when regeneration is not complete, the half liver is enough to maintain normal donor functions due to the immense reserve in the liver.

To donate

• The person must donate of his/her own free will
• The person should be between 18-55 years and weigh between 50-85kg
• The person must be a close relative
• The donor and recipient blood group must match
• The donor liver structure / function, as well as the other systems must be normal
• Half of the donor liver must be enough in volume for the recipient

The suitability in the above respects and some other technical points is determined by the Transplant Team in Pre-transplant donor evaluation which normally takes 2-3 days.

Facts about liver donation surgery

• Modern liver cutting techniques using CUSA have made it safe and blood less
• Normal liver has immense reserve - nearly 70% of liver can be safely removed although much less is removed
• Normal liver grows back very quickly - it can be restored to normal size after removal of half the liver in just 2 weeks

Life after donation

After operation, the donor will stay in hospital for 5-10 days. Another 3-4 weeks of recuperation is required at home. After that, the donor can resume normal activity (except strenuous physical exercise) and return to work 6 weeks after surgery. Sexual activity can be resumed as soon as the donor feels well enough. Heavy physical activity, sports including lifting weights can be resumed 3 months after surgery.

There are no dietary or any other restrictions, and the donor leads a completely normal life with normal liver function without any decrease in the longevity of life or any other long-term consequences.

All the donors in the author's series of patients have led a normal life after donation. None of them have died or had any major complications in the short or long-term. This is also the experience of most teams in the world undertaking such operations. However, among more than 7000 donor operations worldwide, 6 deaths have been reported which gives an expected mortality of around 0.1 %