What is a live donor liver transplant?

The unique anatomy of the liver allows it to be separated into independent anatomic units that are able to retain their normal function (Figure 8). Since 1989 several thousand live donor liver transplant (LDLT) operations have been performed worldwide, most commonly between an adult donor and a pediatric recipient. These procedures have significantly reduced

the number of pediatric patients who die while on the waiting list.

Current data suggest that the results of live donor liver transplants are at least similar to, and perhaps better than, the results of deceased donor liver transplants. Because it can potentially increase the number of people who may benefit from liver transplantation, LDLT poses exciting, new surgical possibilities for adult patients with end-stage liver disease. The basis for taking part of a living person’s liver lies in a healthy liver’s unique ability to grow back or regenerate to normal size for both the donor and the recipient.

In these highly technical operations, the right lobe of the donor’s liver (about 60% of the total liver) is implanted into the recipient. The recipient’s entire liver is removed because it is diseased and functions poorly. After surgery, the rapid regeneration of the liver allows both the donor’s and the recipient’s livers to return to nearly full size. Amazingly, it typically takes the recipient’s liver less than 1 month to regenerate fully. That time frame is a bit longer for the donor, whose liver often takes a full year to accomplish the same feat.

Because the left lobe is the smaller of the two lobes, it can be used as a living donor organ only in children or very small adults. The larger right lobe is needed when the recipient is an average-size or larger adult.