Liver transplantation from live donor; the recipient’s liver is taken out of the living donor immediately after the liver is completely removed is transferred to the recipient.
Doing a favor to someone you love, to give him the opportunity to get rid of the disease, to bring him to life, as much as the opportunity to say there is an indescribable feeling.
The thought of giving you a piece of your liver despite this nice feeling may make you nervous at first. You may be worried about how your life may affect your health in the future.
Note that the liver of the donor for the liver transplant; It starts to grow rapidly after the operation and after approximately 3 months it reaches its former size before surgery. In the same way, the part of the liver recipient grows and reaches normal liver size within 3 months.
When you decide to donate a part of your liver, very detailed investigations will be carried out to prevent your health from being harmed. Your organ donation will not be accepted and the situation will be notified to you and your family if there is a slight doubt that may harm you during these examinations.
There will then be a new volunteer donor (donor).
1. What Are The Conditions For Becoming a Donor?
- The donor should make the donation by his own free will.
- The transmitter must be above 18 years of age.
- The transmitter should be related to the 4th degree.
- The transmitter and the recipient’s blood group should match.
- Transmitter liver structure and function should be normal with other systems.
- The anatomy of the donor liver should be suitable for the recipient and himself.
- The suitability of the above conditions and other technical points is determined by our transport team in the donor (donor) evaluation, which usually takes 2-3 days.
2. Blood Group Match
Blood group :- 0 / A / B / AB
Which blood group :- 0 / 0-A / 0-B / 0-A- B-AB
Which blood group can give :- 0-A-B-AB / A-AB / B-AB / AB
The Rh factor of the donor (+) or (-) has no effect.
3. Life After Liver Donation
- After the operation, the donor should stay in the hospital for 7 – 10 days.
- A home rest period of 3-4 weeks is required.
- After the rest / convalescence period, the donor (donor) may resume normal activities (except physical exercise) and return to work 6 weeks after the operation.
- When the voluntary donor feels well, his sexual activities can be sustained. Sports such as heavy physical activity and weight lifting are recommended to continue 3 months after surgery.
4. What Are The Tests For The Liver Donor?
- All blood and urine tests
- Tumor markers (markers)
- Liver tests
- Viral hepatitis tests
- Infectious disease (such as AIDS) tests
- Lung X-ray
- Heart radiography, echocardiography if necessary
- Abdominal ultrasonography
- Computed tomography for liver volume
- Magnetic resonance cholangiography for biliary tract
5. What Are The Advantages of Live Donor Liver Transplantation?
The main advantage of live donor liver transplantation is; it is possible to provide transportation to the buyer in a timely manner. So when the receiver needs to be transported, the cadaver can be transported without having to wait in order for the transfer to be on the waiting list. Organ donation is extremely rare in our country. For this reason, most of the patients waiting in the list, unfortunately, are deteriorating while waiting for the turn to come, and some patients even lose their lives.
In addition, worsening of the general condition of the patient while waiting for the organ row increases the risk of complications in the early postoperative period and decreases the chance of success after transplantation. If we had enough cadaveric liver, then organ donation with live donor was not taken into consideration.
6. How Much of The Liver of The Donor Is Removed?
Generally 40 to 70% of the liver is removed. The liver is divided into two groups as right lobe and left lobe. The anatomical division of the liver in this way allows us to obtain two separate parts of the liver that can function freely.
The right lobe constitutes an average of 60% of the liver and the left lobe constitutes an average of 40% of the liver. The gall bladder of the donor is also taken during transplantation.
7. How Long Does It Take To Transport The Liver To The Recipient After The Donor Liver Is Removed?
Transmitter and receiver operations are performed at the same time. The liver is transferred to the recipient without waiting.
8. Can Anyone Be Alive?
First, you must be between 18 and 60 years old to be a live liver donor.
It is preferred that the transmitter and receiver are of the same size, but in some cases there are cases in which the transmitter is smaller in size than the receiver. If the donor is a woman, she should not be pregnant. The transmitter should not be overweight, but may lose weight even if it is overweight and become a potential donor.
The donor should not have any chronic disease. The transmitter must be able to understand all the risks of this operation. In addition, it should comply with all the instructions given by the doctors in the short and long term after the surgery.
9. Does The Transmitter Have To Be Related To The Recipient?
In our country, relatives up to 4th degree can be liver donors. The status of the donors without the degree of kinship is evaluated and decided by the Ethics Committee of the Ministry of Health.
10. If I Become A Relative Of The Recipient, Does This Reduce The Risk Of Rejection?
The donor has no effect on reducing the risk of rejection (rejection of the newly transplanted liver) by having a blood bond with the recipient. In addition, the blood link between the donor and the donor does not affect the level of immuno suppressive therapy that the recipient needs after surgery. However, it is possible that identical twins differ in such cases.
11. What To Look For In The Evaluation Process To Become A Living Liver Donor?
The recipient and the blood groups of the donor should be compatible. In the evaluation, it is considered that the donor liver is normal and of sufficient size.
In addition, the donor should not have any psychiatric disorders that will make this procedure difficult. The fact that the donor does not have any infectious disease that can transmit to the recipient is also an important condition. Finally, the transmitter has to be decided by his own free will without any pressure.
12. Can I Have My Own Doctor?
As organ transplantation is a detailed process, it is better to carry out all tests and evaluation by our team. If you live in a place far away from our center, you may have to do some of the assessment at the place where you live, but in any case you should be reviewed by our doctors.
13. What Is The First Step Of Evaluation To Be A Living Liver Donor?
The first step in the evaluation is to determine your blood group. This is a very simple test. If you want, you can have your doctor in any blood center. The transmitter’s blood must be the same as the receiver or “0”. The Rh factor of the donor (+) or (-) has no effect.
14. What Should I Do If I Know My Blood Type?
You can contact our transplantation coordinator. You can ask the question you want on the phone. In addition, detailed personal information will be taken and you will be given an appointment at an appropriate time. Your medical history will be taken and a wide physical examination will be performed.
The attending physician will inform you about live donor liver transplantation and will tell you the risks of this surgery and the statistical data in our center and in the world. This appointment will give you a wide blood test. If your results are reviewed and everything is desired, step 2 will be planned.
15. What Is The 2nd Step Of Evaluation To Be A Living Liver Donor?
The next step in the evaluation is to look at your abdomen and liver in detail with ultrasound and computed tomography (CT).
The size and blood supply of your liver are measured. IT gives us detailed information about your liver, plays a major role in the decision phase.
In addition, a team of hepatologists and a surgeon will evaluate you. Tests other than this may gain importance depending on your situation.
16. Should I Stay Hungry Before My Appointments?
You should come to the computerized tomography (CT) imaging for 3-4 hours. For MRCP (Magnetic Resonance Cholangio Pancreatography) you should stay hungry for 8 hours. But in general, you are not required to open appointments unless specifically mentioned.
17. Should My Family Be With Me On Dates?
It is important to have a relative or relative with you when you arrive at the appointments. So they know something about the procedure. In all these appointments, the transmitter and his family can ask all the questions and find out more. It is recommended that your accompanying companion be with you until the final appointment.
18. When Can I Find Out If I Can Be A Donor For Liver Transplantation?
In general, you will be informed immediately after you finish the assessment. Sometimes it may be necessary to have further medical tests, which are thought to affect your surgery. It is extremely important that you understand the information provided to you. The decision to donate your liver is a serious decision.
19. Who’s The Last To Decide I Can Be A Donor For A Liver Transplant?
After completing all the necessary tests, our team will meet and review the results. Our liver transplantation team; there are physicians, surgeons, nurse coordinators, radiologists, anesthesiologists, psychiatrists, and consultant physicians who have evaluated you in appointments. The decision will never be individual; The decision is always given as a team. The decision always takes into account the health of the donor.
20. Who Decides The Date Of The Transfer If I’m Certain To Be A Donor For Liver Transplantation?
The surgical team, the recipient and the donor, together take a common decision for the date of transplantation. Depending on the severity of the condition of the recipient, doctors prefer this surgery as soon as possible. In this case, the donor begins and prepares the surgery. Coordination of operating room is also important. There are 2 operating rooms and 2 surgeons, nurses and anesthesiologists.
21. Should The Cause Of The Recipient’s Liver Disease Affect My Decision?
The donor volunteers a great sacrifice to give a part of his liver. This sacrifice will save the buyer’s life. Some diseases (such as hepatitis C and liver cancer) may relapse after transplantation.
Before the operation, what is expected of this transplant, possible complications and the current medical condition of the recipient will be discussed with you. Confidentiality is essential in these conversations and the same sensitivity is expected from the donor. Speaking of these issues with the donor will not be hidden from the buyer.
22. What Are The Potential Risks Of Liver Donor Surgery?
The risk of death in donor surgeries is 0.2%. This is a very low risk. Postoperative bleeding and bile leakage risk may occur. This may rarely require blood transfer and reoperation. Although the incidence of all these complications is very low, the risk is always present.
All possible risks will be explained to you in detail during the assessments. Small bile leaks, small wound infections and some gastrointestinal disorders (constipation, digestive difficulty, nausea) are the most common complications. These complications usually improve within a few weeks.
23. Those Who Are Curious About The Operation Of The Liver Donor?
Is The Gall Bladder Taken During Liver Donor Surgery?
The gallbladder is taken during liver transplantation. However, this situation has no negative effects on the transmitter’s later life.
24. Will Blood Transfusions Be Delivered To The Donor During Liver Donor Surgery?
Although the blood transfusion for the donor is very rare, it may sometimes be needed.
25. Should I End My Alcohol Use Before My Liver Donor Surgery?
If you are going to be a liver donor, then you should not use alcohol. If you have used alcohol in your history, you should inform our doctor.
Drinking alcohol is not an obstacle to your donation, but liver biopsy may be needed to check for any damage to your liver.
26. Should I Cut My Medication Before Evaluation or Surgery To Become A Liver Donor?
Do not interrupt your medication until our doctors tell you. You should cut aspirin and similar drugs 7 days before the liver biopsy or surgery.
Such drugs prevent the coagulation and increase the risk of bleeding considerably. For women receiving birth control or hormone replacement therapy, it is recommended to discontinue these medications.
Such medications increase the risk of complications in the postoperative period because it enables the blood to clot more quickly.
27. I’ll Be The Liver Donor; How Far Will I Stay?
The minimum rest period after surgery is 4-6 weeks. As the healing process will change from person to person, it may take 8-12 weeks for pain and fatigue to pass.
28. Will There Be Traces After Liver Donor Surgery? How Much Is The Permission Size?
The surgical incision is in the form of “J” or the reverse “Y” called “Mercedes”.
In most cases, the incision is healed quickly and gradually decreases. However, the surgical scar is permanent and will always be visible.
29. Will I Have Much Pain After Liver Donor Surgery?
After the operation, your pain is checked with the epidural catheter for the first 3 days. Pain management is then provided by oral medications.
30. Will I Have A Normal Life After Liver Donor Surgery?
If there are no complications, we expect you to return to your old life in about 3 months. There is very little risk of complications in the long term.
31. When Can I Go Back To My Sexual Life?
A couple of weeks, you probably won’t want to go back to your sexual life until you get your strength back. What is important about this is how you feel as a distress and power.
32. How Long Should I Wait After The Liver Donor Operation To Get Pregnant?
It is not possible to give a definite date for this question, but we recommend that you do not become pregnant for at least 6 months after the operation.
33. When Can I Start My Birth Control And Hormone Replacement Therapy Again After Liver Donor Surgery?
We recommend that you wait at least 3 months after the operation.
34. When Does My Liver Reach Its Normal Size After Liver Donor Surgery?
The liver begins to regenerate itself immediately. The most intensive regeneration takes place in the first 2 weeks. At the end of 3 months, the liver reaches a size close to the old or the old.
35. In The Future, Can I Forgive A Part Of My Liver Again?
No. Once you have donated a certain part of your liver, you cannot forgive it for a second time.
36.When Can I Drive After Liver Donor Surgery?
It is recommended that you do not drive 4 weeks after the operation. Before you decide to drive a car, you should be physically and mentally intact, and your reflexes are on the spot, and most importantly, you shouldn’t have a problem with your abdominal area.
37. When Can I Start Exercising After Liver Donor Surgery?
As soon as you wake up from the anesthesia, you will start doing “exercise”. You will be asked to do breathing and coughing exercises. You will also be asked to periodically squeeze the muscles on your legs. 24-48 hours after the operation, you will get out of bed and help. Walking is important in the healing process. Being able to rise as quickly as possible, reduces the risk of many postoperative complications (such as blood clotting, pneumonia, muscle loss). A walking program will be prepared to apply in your home. In this way, within two to three months to reach your old health is targeted.
38. When Can I Start My Tiresome Activities Such As Jogging, Swimming, Lifting Weights After Liver Donor Surgery?
In the first 6 weeks, you should take care not to lift particularly heavy until your abdominal wall is healed. Do not remove more than 5 kg.
If you feel good after 6-8 weeks and you don’t have any complications, you can return to your normal daily activities. These include jogging, swimming, aerobics and cycling.
However, you should be very careful in abdominal exercises. You should start slowly and increase your strength and endurance with a few repeat exercises.
39. When Can I Travel or Fly?
Do not plan to go abroad for at least 4 weeks or 8-12 weeks. If you live outside of Istanbul, you want to return to your home and you can go to the controls in your city, if you have a physician who knows about living donor liver transplant you can return home after 2-4 weeks. We must remind you that you will be recalled to our center for evaluation and treatment if you are in the slightest complication. At the end of the 12th week you can travel anywhere you want.
40. How Long Will I Be In Hospital After Liver Donor Surgery?
The mean duration of hospital stay is 7-10 days.
41. When Liver Transplantation Is Scheduled, Will The Transplant Definitely Occur?
Unfortunately, many cases can change our plans when it comes to liver transplantation. The condition of the recipient may worsen and become non-transferable, or there may be a condition in the recipient that needs to be treated prior to infection or the like. In this case, postponement of the transfer may be in question.