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Living-donor liver transplant is an option that is offered by Lurie Children’s — working with Northwestern Memorial Hospital — to the parents of infants and young children who require a liver transplant.
Selecting a Donor
The potential living liver donor must meet certain age and health criteria, as well as have the same or compatible blood type as the recipient.
In good health: The donor should be of overall excellent health without significant medical problems such as diabetes, heart disease, hypertension or a history of hepatitis.
Age limit of 50 years: We may consider individuals over the age of 50 in special circumstances as potential donors.
Donor willing and able to donate: Most importantly, the donor must be willing and able to withstand the stress of donation and recovery from major surgery.
Blood types checked: We encourage parents to have their blood types checked to determine if one, or both, match. If both are a match, the family needs to decide who would make the most suitable donor. Some issues for consideration are: employment (who is the primary breadwinner), work demands (sedentary or physical), sick-leave limitations and available support systems.
The donor work-up is initiated when a suitable donor is identified. The donor evaluation consists of:
Medical and psychosocial exam
CT scan of the liver to measure size and rule out abnormalities. An MRI may also be done if further clarity is required.
Liver biopsy, if needed
Angiogram, if needed
Additionally, the donor usually will donate at least two units of blood for the procedure.
Because living donors are adults, all donor evaluation and testing procedures are performed at our adult partner hospital, Northwestern Memorial Hospital, located one block away. Once the donor work-up is complete and the potential donor deemed suitable, the transplant teams from Northwestern and Lurie Children's work together with the family to select a date for the transplant.
The infant or child is admitted to Lurie Children's transplant unit the night before the scheduled surgery, and the donor will report to Northwestern Memorial by 6 a.m. on the day of surgery. The donor operation begins about 7:30 a.m., and the two transplant teams are in constant communication thereafter.
Once the donor segment is removed, the team at Lurie Children's starts the recipient procedure.
While the donor operation normally takes four to six hours, the recipient procedure may last up to 14 hours.
Pros & Cons
The most important advantage to living-donor liver transplant is the ability to schedule the surgery on an elective basis. T his allows the transplant team, along with the family, to decide on the optimum time for the procedure without the uncertainty of the waiting list. The recipients are usually healthier and stronger at the time of transplant as well.
Shorter Hospital Stays; Less Rejection
Living-donor recipients have shorter hospital stays and may have fewer episodes of rejection.
It is Major Surgery
On the other hand, the family must endure two procedures rather than one. The living-donor operation, while very safe, is a major surgery with significant risks. These risks include bleeding (the most common), infection, bile leak, gastric motility problems and digestion problems.
Typical Donor Hospital Discharge & Return to Work Status
Most donors are discharged from the hospital within three days and back to work within six to eight weeks.