Donor and Recipient

Basic facts regarding the Recipient:

• Patients being considered for LDLT are those who are candidates to receive a cadaveric liver (liver from non-living, unrelated individual) based on the severity of their liver disease and its complications. These patients are placed on the liver transplant waiting list and will not be denied a donor liver if it becomes available prior to LDLT. Thus, failure to find a suitable donor for LDLT will not jeopardize the recipient's chances of receiving a cadaveric liver

• Patients considered for LDLT will be followed by the same USC liver transplant team who will manage all complications of liver disease with a view to optimizing the patient's condition prior to liver transplant.

Basic facts regarding the donor:

• The donor could either be a relative (close or distant) or even be unrelated.

• The blood type of the donor should be the same as the recipient's.

• The donor should be in good physical and mental health.

• The decision to be a donor should be made after careful consideration of facts and knowledge of the procedures, the risks and complications.

• There should be no evidence of financial gain arising out of the donation.

• The donor must be relatively close in size (or larger) than the recipient.

What constitutes a good donor?

A good donor is someone who is in good physical and mental health, older than the age of 18 and free from:

• HIV infection
• Known viral hepatitis
• Active alcoholism with frequent and heavy alcohol intake
• Psychiatric illness under treatment
• History of malignancy
• Heart and lung disease requiring medications
• Diabetes mellitus of greater than 7 years duration

What is the process for evaluating a donor?

• The potential donor will be asked to complete a questionnaire that includes attaching a copy of his or her blood type (to confirm whether this is compatible with the recipient).

• If the blood type is compatible with that of the recipient and the details on the questionnaire indicate suitability, the donor is evaluated by an internist (liver specialist or hepatologist) who will obtain additional history, perform a physical examination and administer appropriate blood and urine tests.
  BLOOD TYPE COMPATIBILITY CHART

  Blood Type Can receive liver from: Generally can donate a liver to: O O O, A, B, AB A A, O A, AB B B, O B, AB AB O, A, B, AB AB

• If the physical examination and tests confirm that the donor is suitable and the donor's size (height/weight compared to that of the recipient) is appropriate, a CT scan will be arranged to calculate the volume of liver that will permit a successful outcome. [Prior to having the CT scan the donor must notify the team of any allergies to iodine or radioiodinated contrast.]

• At this stage, the potential donor will also be interviewed by a social worker from our team. Under some circumstances, a psychiatric evaluation may be appropriate.

• When complete, the medical and social details of the evaluation are discussed at a conference by the transplant team members.A decision regarding the suitability of the donor will be made at that time. This decision will be communicated to the donor by one of the team members (usually the transplant coordinator). If not selected, physician team members can be contacted for explanation. [All information concerning the donor is kept in strict confidence.]

Related links:

• World's first adult-to-adult LDLT without blood transfusion
• Pediatric Liver Transplant