Living Donor Liver Transplantation
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1 Patient information Queen Elizabeth Hospital fl/igj Birmingham Part of University Hospitals Birmingham NHS Foundation Trust Birmingham Children's Hospital rliifj NHS Foundation Trust Living Donor Liver Transplantation
2 Information for donors This leaflet provides information to potential donors, families and recipients waiting for liver transplant at the Queen Elizabeth Hospital, Birmingham and Birmingham Children's Hospital. Living donor transplantation Advantages to living donation include: A shorter waiting time for your transplant You will receive a high quality liver The surgery is planned (elective) for a particular date Donation provides an opportunity for a family member or friend to make a "gift of life" to a child, relation or close friend Other considerations Live-liver donation is an important alternative to traditional forms of liver transplantation and should be considered carefully. The members of the transplant team invite you to discuss this treatment option with your doctor and the live-donor co-ordinator in clinic where they can answer any questions you may have. Why consider living donor liver transplantation? Our transplant programme encourages patients and their families to consider the opportunity of living donor liver transplant. This is an important choice to help meet the organ shortage. Adults Adults on the liver transplant list in the United Kingdom currently wait up to a year or more for a liver transplant. Unfortunately, 22% of patients waiting for transplants will die before a liver becomes available from a deceased donor. 2 I Living donor liver transplantation
3 Paediatrics A small number of children die on the transplant waiting list (nationally 1-2%). For small children we have a very good system nationally for splitting livers which will nearly always provide a suitable graft. For children weighing 20-SOkgs, finding a suitably sized liver is more difficult and this can delay transplantation. The option of a live-liver donation is something that many parents wish to consider for their child. Who can be a donor? Donors must be: A blood relative, spouse, or friend who share a compatible blood group with the patient Between the ages of 18 and 60 years In good health and a suitable size Freely willing to donate Live-liver transplantation is not possible, or suitable, for some transplant candidates. The work-up process The live donor assessment is performed at the Queen Elizabeth Hospital Birmingham by a team of doctors and a live liver donor co-ordinator, who are not involved with the person needing the transplant. The live liver donor transplant co-ordinator will provide information about living donation and organise the assessment process. This will involve information from your GP as well as blood tests, chest X-ray, CT and MRI scans. There are also important meetings with members of the transplant team (surgeon, physician and psychiatrist) who will determine your suitability for living donation and ensure this is the right decision for you and your family. As part of the process Living donor liver transplantation I 3
4 an independent assessor will meet with you to offer a legal and impartial assessment of the donor's candidature. Once the potential donor is accepted a date for surgery will be chosen. The donor has the right to withdraw their offer, or the transplant team may decide it is inappropriate to proceed with liver donation, at any stage in the proceedings. What does the operation involve? The donor surgery lasts about 6 hours. The surgeons remove about half of the donor's liver (depending on whether donation is to an adult or child), which is then transplanted into the recipient. Within 6 to 12 weeks the liver regenerates (grows) to approximately 90% of its original size and function returns to normal. The hospital stay is on average between 7-10 days. Donors can usually return to work after 6 to 12 weeks. What are the risks to the donor? Live liver donation is major intervention and inevitably there are potential risks associated with this kind of surgery. These include: Problems with the anaesthetic, wound infections, pneumonia and blood clots in the lungs or legs Bleeding Bile leakage Psychological stress Death (1 in 200 for right lobe) (1 in 500 for left lobe) It must be noted however that the vast majority of donors do extremely well and recover quickly from their surgery. The risks will be discussed at length when donors meet with the transplant team. 4 I Living donor liver transplantation
5 Fig. 1 The donor liver is divided into two, with either the right lobe or left lobe being given to the transplant candidate and the rest remaining in the donor. The liver re-grows to its full capacity within the space of a few weeks. Cl).c 0...J...,... Cl)...J c c - o E u E.;::::; o ru u..c c O u E -5 E a; O= u..0..c c Ol ;:: Q) c >.. s.!:::! Q) t:: Q) Q) >..c 0 u.;::::; c Q) Q)..c t::'. ru -+-- Q) _J rn... O c 0..- Q)..c > Ol 0::: Cl).c 0...J...,..c - cc:: ru... O c Q)..c > Ol 0:::..c _Qi Q) <ii > _J O Living donor liver transplantation I 5
6 Please use the space below to write down any questions you may have and bring this with you to your next appointment. 6 I Living donor liver transplantation
Living Donor Liver Transplantation
The Leeds Teaching Hospitals NHS Trust n Living Donor Liver Transplantation Information for patients This leaflet provides information to potential donors, families and recipients waiting for liver transplant
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