Living Liver Donor

 — When Kelly Kinkade was told she needed a liver transplant, she assumed she would be placed on a list.

She would wait until someone with similar blood type and body size died, and then be contacted for surgery.

But a second option also existed.

As medical technology has advanced in the past 20 years, living-donor liver donations have increased. Surgeons can take a portion of the organ from a healthy person and implant it in the recipient. It offers an alternative for patients such as Kinkade, who would otherwise have to wait up to 10 years for a liver.

 

But because it's relatively new, few people are aware that they could provide a new life for those suffering from liver failure.

"People don't realize that it's possible. You hear so much about the other potential transplants," Kinkade told the Daily Journal (http://bit.ly/1fMsVy0 ). "There are probably a lot of people who have the heart to help others, but they don't know that they have the opportunity."

Traditionally, liver transplants have been conducted with a liver donated from someone who has died.

But the liver is unique in that only a portion needs to be removed to be used in a transplant.

It is the only internal organ with the ability to regenerate after it has been damaged, said Lori Clark, a registered nurse at Northwestern Memorial Hospital in Chicago, Ill.

Within 90 days of the transplant, it can grow back to a healthy size.

The liver is one of the few organs in the body that can be taken from a living donor. Kidneys and parts of the pancreas, lungs and intestines also can come from a living person.

Living-donor liver transplants have been performed only since 1989, when a portion of an adult liver was placed in a child. Four years later, the first adult-to-adult transplant was done.

Nearly 5,000 of the procedures have been performed in the U.S., according to the United Network of Organ Sharing.

Potential living donors have to be the same blood types as the transplant patient, they have to be 55 years old or younger, and they have to have a healthy weight-to-height ratio, according to Clark.

To start the process, doctors have to take a battery of blood tests to determine liver health.

Taking a scan of a potential donor's liver, doctors determine that the vein and artery providing fresh blood to the liver, as well as the bile duct, were large enough to allow for a transplant.

Living donation brings with it complications that other transplants don't. Because it's a major surgery, donors could experience severe bleeding, infections, bile leaks or hernias, according to Clark.

The possibility of death is always present with a surgery on a major organ, Clark said.

But psychological effects also are a risk. The donors are left with a scar that can impact their body image. They often feel depression, anxiety or stress after the surgery.

If the recipient rejects the organ, it can lead to anger and feelings of hopelessness.

But for those who need it, living donation can be the only way to get the transplant.

"The doctors have told me it will be years until I could get a liver otherwise," Kinkade said. "Living donation is my best shot."

In living liver donor surgery, a surgeon removes a part of the donor's liver, typically the right half. This donated segment of the liver is then immediately placed in the recipient in the next operating room.

The remaining part of the donor's liver is sufficient to maintain normal body functions. The recipient also receives a large enough segment of the donor liver to maintain body functions.

During approximately the next two months, the remaining and transplanted parts of the donor liver grow to normal size, providing normal long-term liver function for the donor and the recipient.