Living Donor Liver Transplant
The University of Maryland Medical Center (UMMC) offers every patient the possibility of a living donor liver transplant. For patients who have a donor available, this procedure promises quicker recoveries, better transplant results and reduced waiting times.
In recent years, UMMC has been among the 8 largest living donor liver transplant centers in the United States. That expertise means we are among the most experienced in safely removing part of the donor’s liver to help the recipient resume a normal life as quickly as possible.
Living liver donation involves an extremely complex surgery that must remove part of a person’s liver and place it in the recipient’s body. The experience of the surgical team should be your first consideration when choosing your living donor center.
We have a specialized living donor surgical team that completes all of our live donor surgeries. This skilled team has extra training and expertise in living donor procedures.
Features of our care include:
- Specially trained surgeons: Our living donor liver surgeons have each spent time working in hospitals in Turkey and Korea. These nations perform the highest volumes of living donor liver transplants in the world, and our surgeons sought training opportunities that would provide a high volume of experience. Meet our team.
- Dedicated living donor nurse coordinators: Our dedicated nurse coordinators work with all living liver donors. They are highly familiar with the needs, questions and experiences of living donors and will be there for you throughout the process. Meet the transplant nurse coordinators.
- Clear operating roles and procedures: We have established a clear procedure for these complex surgeries. The same people handle the same duties in each operation, which leads to a proven record of success.
Because liver transplantation is such a successful procedure, doctors are recommending this procedure for more and more patients. Unfortunately, there are not enough donor organs available, which means that more people are waiting for transplants.
To solve this problem, surgeons can remove a portion of a living person’s liver and implant it in the liver recipient. The liver regrows to its full size in both people.
In addition to making more liver transplants available, patients who receive living donor transplants experience these advantages:
- Transplanting patients earlier in the liver disease progression often prevents them from becoming very sick. They also recover faster from the transplant surgery.
- The graft – the new liver – is more likely to survive when it comes from a living donor.
- The recipient’s body is less likely to reject the donated organ (graft).
- Recipients spend less time on the waiting list.
Learn more about liver disease and liver transplant.
The best candidates for living liver donation are family members or close, personal friends of the recipient. Liver donation is a major abdominal surgery and a serious commitment.
Living donors should meet these criteria:
- Have an important personal relationship with the recipient
- Come forward to donate willingly
- Be between the ages of 18 and 60
- Have a compatible blood type with the recipient
- Be in excellent health
- Not have uncontrolled high blood pressure, liver disease, diabetes or heart disease
- Be about the same physical size as the recipient, or larger
We consider living liver donation for all patients. Ultimately, the safety of the recipient and donor determine whether a live donor transplant is an option.
In general, the following guidelines make patients most likely to benefit from a living donor liver transplant:
- Patients must have a relative or close friend who is willing to donate a portion of their liver and who is a compatible donor.
- Eligible recipients usually have symptoms of liver failure and have MELD scores (Model for End-Stage Liver Disease) that do not let them receive a transplant in a timely manner. The MELD score ranks how sick a patient is and how much they need a transplant.
- Recipient MELD scores must be greater than 12 but less than 25 to receive a living donor liver transplant.
- In competitive transplant regions like the one UMMC is in (UNOS Region 2), patients with lower MELD scores are likely to be on the waiting list for a long time before a traditional (cadaver) transplant becomes available.
Donating a portion of your liver is a generous gift of life. Part of the donor’s liver is resected (removed) in an open abdominal surgery.
We schedule the operation at a time that is convenient for both the donor and recipient. This surgery involves the following steps:
Before the procedure:
- On the day of the operation, donors and recipients come to our Same Day Surgery unit. We will do some final tests to make sure you are ready. These might include a physical exam, blood work, X-rays, an EKG or other tests to make sure you do not have an infection or other issue that could cause problems with the transplant.
- In operating rooms that are next to each other, we gently put the donor and recipient to sleep and prepare for surgery.
- We make an incision under the donor’s rib cage and carefully assess the actual size of the liver, which we’ve already seen with a CT (computed tomography) scan during the evaluation.
- The surgeons remove the donor’s gallbladder and inject dye into the biliary tree (the bile ducts and gallbladder) to make sure it is safe for division. Then they dissect the portal vein and artery where it divides the different sides of the liver. They isolate the vein that drains that part of the liver and divide the liver in half very carefully.
- The surgeons close the surgical incision. The patient goes into recovery.
- Meanwhile, surgeons immediately implant the resected (surgically removed) liver in the recipient.
- The liver transplant surgery usually takes 4 to 8 hours as surgeons reattach blood vessels and bile ducts.
After the procedure:
- We aim to have the donor up and out of bed the night of the surgery. The morning after surgery, they can walk down the hallway to visit their liver recipient.
- Most donors go home about 5 to 6 days after surgery.
- Within about 2 months, the liver re-grows to its original size in both the donor and in the recipient.
We know that donors have lots of questions. If you are considering donation, we will assign you a donor advocate from our social work department.
The donor advocate can help you to figure out your best interests privately, outside of conversations with the surgical team. We want you to feel comfortable asking questions during every step of the process.
For additional information about living donor liver transplant, please call the Transplant office at 1-410-328-3444.
If you are interested in becoming a living liver donor, please click below to download our questionnaire.
For referring physicians: To refer a patient or get more information, please call 1-800-373-4111. A physician service representative from Consultation and Referral Services will direct your call to the appropriate physician or department.
For more details, please visit our section for referring physicians.