Frequent Questions and answers on LDLT

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http://www.lahey.org/medical/livertransplant/livedonor/livedonor_faq.asp

Frequently Asked Questions about Live Donor Liver Transplantation (LDLT)

What is live donor liver transplantation?

Live donor liver transplantation (LDLT) is a procedure that involves a living

donor giving a portion of his or her liver to a family member or close friend in

need of a liver transplant.

Who is a candidate for this procedure?

Candidates, or recipients, are those individuals with advanced but stable liver

disease who have been accepted and listed as appropriate cadaveric liver

transplant recipients.

How can I be considered for LDLT?

After being accepted and listed as a cadaveric transplant candidate, the

transplant team will review your medical information to determine whether or not

LDLT is a potential option for you.

Who can be a donor?

Donors are relatives or close friends with a significant emotional tie to the

recipient. They must have a compatible blood type and body size, as determined

by the recipient's height and weight. In addition, donors must be between the

ages of 18 and 60. They must also test negative for active or chronic hepatitis

B and C and can have no serious medical conditions such as diabetes, cancer or

heart disease.

What is the evaluation process for donors?

After initial screening blood work is received and reviewed, a potential donor

is scheduled for a consult with a transplant nurse and surgeon. This consult

involves a discussion of the procedure itself, as well as an opportunity for the

donor to ask any questions.

The potential donor is then scheduled, along with the recipient, for a CT scan

to evaluate liver volume and vascular anatomy. More extensive blood work is also

completed at this time.

If the donor is accepted based on his or her liver anatomy, a comprehensive

two-day evaluation is then scheduled. This evaluation includes an ultrasound,

preoperative testing, and consults with a physician, psychiatrist and social

worker. If a potential donor completes this evaluation and is accepted as a

suitable donor, surgery is scheduled.

For additional information, please refer to the " Donor Evaluation Process "

section.

When will I have my surgery?

Surgery is typically performed approximately 2 to 4 weeks after the evaluation

has been completed.

How is the surgery performed, and how long will it take?

Simultaneously, two separate surgical teams perform the donor and recipient

surgeries. As one team works on removing the diseased liver from the recipient,

the other is working on removing a portion of the donor's healthy liver.

Typically, the right lobe of the donor's liver is removed, which accounts for

approximately 60 percent of total liver volume. Once the healthy liver has been

removed, it is then implanted into the recipient. The donor surgery typically

takes about 6 hours, and the recipient surgery about 5 hours.

How will my family know what is happening during surgery?

Our family waiting room is staffed by a nurse liaison who will provide frequent

updates to the families of the recipient and donor throughout the surgery.

What will happen after surgery?

Following surgery, the donor and recipient are taken to the Post-Anesthesia Care

Unit (PACU) for careful monitoring by physicians and nurses. The recipient will

wake up with a breathing tube in place. Doctors and nurses will check the

functioning of the recipient's new liver frequently through blood tests, urine

and bile production measurements and other tests, as needed. Once the donor or

recipient's condition is stable, he or she is moved to the transplant unit for

the remainder of his or her hospital stay.

How long will I be in the hospital?

The average recipient will be in the hospital for 10 to 14 days. The average

donor will be in the hospital for 7 to 10 days.

How long do we need to stay in the area following surgery?

The recipient will need to stay in the area for 6 to 12 weeks following hospital

discharge for weekly blood work and visits to the transplant clinic. The donor

will need to stay in the area for approximately 1 week following discharge.

How long are donors followed?

Donors must return for follow-up appointments at 1 month, 3 months and 1 year.

Will my insurance authorize and cover this surgery?

Insurance coverage for liver transplant surgery differs, depending on your

insurance carrier and your specific health plan. Please refer to the " Financing

Your Transplant " section of our site or contact financial coordinator Pat Hogan

at 781-744-2500 with any insurance-related questions.

Who should I contact to learn more about LDLT?

For further information, please contact Morin, MSN, RN, at 781-744-2500.

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