Before Surgery: Donor Evaluation Process
A living-donor candidate must complete the following evaluation process to determine if they can safely donate:
- A blood test determines if the donor's blood type is compatible with that of the recipient. Additional tests are performed to test for healthy functioning of the donor's liver, kidneys and thyroid, and to screen for exposure to transmittable viruses such as hepatitis and HIV, the virus that causes AIDS.
- If the donor's and recipient's blood types are compatible, a physical examination with a CLDT physician is scheduled to further assess the donor's overall heath.
- Consultations with the CLDT's social worker and psychiatrist are scheduled with the donor and their designated care-partner.
- Magnetic Resonance Imaging (MRI) is performed to create a detailed anatomical "road map" of the donor's internal organs to aid the surgery.
- Sometimes additional testing, such as pulmonary function, echocardiogram, or exercise stress testing, is required.
The standard time required to complete the donor evaluation process is two to four weeks, in rare emergency situations, however, it can be completed in as little as 48 hours.
The Donor's Procedure
Depending on which part of the donor's liver is removed, the incision is either straight up and down, or a four-inch incision at the bikini line. For a full right lobe and left lobe donation, the gallbladder is removed. The donor's liver is carefully split into two segments and one portion is removed for the recipient. The surgeon then closes the incision with self-absorbing sutures. The liver immediately beings to heal and regenerate itself, generally taking six to eight weeks for full regeneration.
How long does the donor remain hospitalized?
Typically, a donor remains in the hospital for four to seven days after surgery. Donors spend their first night after surgery in the Surgical Intensive Care Unit for close monitoring by specialized nursing staff. The following day, they are usually transferred to the general surgical floor where the nurses are specifically experienced in caring for liver donors.
Donors are encouraged to get out of bed and sit in a chair the day following surgery, and to walk the corridors as soon as they are able. To make the donor's immediate recovery as comfortable as possible, Columbia University Medical Center provides Patient-Controlled Anesthesia (PCA) which enables self-administration of pain medication following surgery.
Every donor's recovery time is different. Typically, donors spend three weeks recuperating after surgery. In the month following discharge from the hospital, donors return to the Center for Liver Disease and Transplantation for outpatient monitoring. Individual recovery rate and the type of occupation dictate how soon a donor can return to work. It commonly averages three to six weeks. The CLDT's clinical staff helps donors determine when it is safe to resume normal activities.