Living donor liver transplantation involves a living person donating part of their healthy liver to a recipient in need of a transplant. The donated portion grows back to full size in both the donor and recipient within a short period of time. Potential living donors must undergo extensive medical evaluation to ensure the safety of both the donor and recipient. The surgery involves removing a portion of the donor's liver, usually the left lateral segment or right lobe, and implanting it into the recipient to replace their diseased liver. Both procedures take several hours to complete.

1. Living Donor Liver
Transplantation
BY : MOHAMMAD NOUR ALSAEED
GROUP : 3
COURSE :6TH

2. What is a Living-donor Liver Transplantation?
A living-donor liver transplantation, or transplant, is when a
live person donates a part of his or her healthy liver. The
donated part then grows to full size in the person who
receives it (the recipient). After the transplant, the donor’s
liver also grows back to full size over a very short period of
time, usually days or weeks. Sometimes, however, it can
take up to several months.
The donor may be a family member, such as a parent,
sister, brother, or adult child. The donor can also be a
husband or wife.

3. A living-donor transplant means a patient can have a
transplant before their liver failure gets worse. It means a
shorter wait time for a liver. Because the surgery can be
planned in advance, the chance for a successful transplant
is better.
Also, the quality of the liver may be better, because living
donors are usually young, healthy adults who have gone
through a complete medical evaluation.
With a living-donor transplant, the preservation time (the
time when the liver is without blood) is usually minutes,
instead of hours.

4. People who want to donate their liver go through a complete medical exam
to make sure their liver is healthy and that it is safe for them to donate.
Safety is important for both the donor and the recipient. The risk of death is
real. Talk about the risks with your doctor. In general, liver donors must:
• Be at least 18 years old. Most donors are also under 60 years old.
• Be in good health with no major medical or mental illnesses.
• Be a non-smoker for at least four to six weeks before surgery.
• Be able to understand and follow instructions before and after surgery.
• Have a compatible blood type.
• Have an emotional tie with the recipient.
• Not have a selfish motive for donating. Paid donation is illegal in the U.S.
• Have a similar body size.
• Be able to go through certain medical tests like blood work, radiology
studies, and possibly a liver biopsy.

5. Blood tests. The first test is to find out if the donor's blood type matches the
recipient’s blood type. Next, the transplant team will measure liver and kidney
function as well as red cell, white cell, and platelet counts. The donor is also
tested for viruses such as hepatitis B, hepatitis C, Doctors also look for signs of
common liver diseases
Ultrasound/MRI/CT scan. These tests are done to get “pictures” of the liver to
make sure the donor’s bile ducts, arteries, and veins are the right fit for the
intended recipient. These pictures will also look for benign and malignant
tumors, which are rare, but are sometimes found.
Chest X-ray and EKG. These are standard tests done before any major
operation to check for lung or heart problems.
Consults. Every donor will meet with a social worker or psychiatrist to talk
about their reasons for donating a liver and to make sure they are in a stable
mental condition for the surgery.

6. Right lobe donation
involves removing
segments 5, 6, 7, and
8.
Left lateral segment
donation involves
removing segments 2
and 3.
Left lobe donation
involves removing
segments 2, 3, and 4.

7. We schedule the operation at a time that is convenient for
both the donor and recipient. This surgery involves the
following steps:
1. Before the procedure:
2. Donor procedure:
3. Recipient procedure:
4. After the procedure:

8. 1. 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.
2. In operating rooms that are next to each other, we gently put
the donor and recipient to sleep and prepare for surgery.

9. 1. 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.
2. The surgeons remove the donor’s gallbladder and inject dye
into the biliary 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.
3. The surgeons close the surgical incision. The patient goes
into recovery.

10. 1. Meanwhile, surgeons immediately implant the resected liver
in the recipient.
2. The liver transplant surgery usually takes 4 to 8 hours as
surgeons reattach blood vessels and bile ducts.

11. 1. 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.
2. Most donors go home about 5 to 6 days after surgery.
3. Within about 2 months, the liver re-grows to its original size
in both the donor and in the recipient.