Nationally, more than 15,000 patients are waiting for a liver transplant. Approximately 6,300 persons each year will receive a new liver; 1,400 die waiting. In California, one in four listed for liver transplant will die before an organ becomes available. Fortunately, living donation is now a lifesaving option at UC San Diego Health.
“Living liver donation is an extraordinary gift that family and friends can make to a loved one who is suffering from advanced liver disease,” said Alan Hemming, MD, professor of surgery at UC San Diego School of Medicine and chief of Transplantation and Hepatobiliary Surgery at UC San Diego Health. “With a national shortage of available livers, this is an increasingly needed option that saves lives and helps select patients avoid the risk of waitlist mortality.”
“Unlike any other internal organ, the liver can regrow,” said Hemming, who has performed more than 1,000 liver transplants and resections. “Surgeons can remove half of the healthy liver from the donor and transplant it into the recipient. Regeneration of the liver in both the donor and recipient begins immediately, with the liver in both patients returning to 80 percent of its original size within 6 weeks with further growth up to one year.”
UC San Diego Health surgeons are the only team currently performing live donor liver transplantation in San Diego and have performed seven of these procedures in the previous year.
Hemming added that the patients who are most likely to benefit from a living donation are those who require listing for transplantation but whose Model for End-Stage Liver Disease, or MELD score, is not high enough that a liver will be allocated. MELD is a scoring system for assessing the severity of liver disease with livers allocated by federal policy to those who are the sickest. Earlier access to liver transplantation through living donation allows patients to be transplanted while they are less critically ill and better able to get through the demanding process of liver transplantation.
In patients who have a qualifying living donor, transplantation can be scheduled electively at a time that is optimized for the recipient and before the onset of life-threatening complications. Life expectancy for the recipient is 90 percent at one year. Risks to the recipient are similar to those for standard liver transplantation.
“This is a surgery that carries risk for the donor with potential complication rates of approximately 25 percent,” said Hemming. “Patients and families should only make a decision about living donor transplantation after being fully informed of the risks and benefits. The increasing need for liver transplantation, lack of available organs and the high death rate for patients on the waiting list has made living donor transplantation a much needed option despite the recognized risks to the donor.”
Living donor transplant surgery requires the coordination of two transplant teams. During surgery, the donor and the recipient are placed in side-by-side operating rooms. One team removes half of the donor’s liver, typically the right half, which is immediately transplanted into the recipient by the second surgical team.
Donors must be less than 60 years old and in excellent health with liver anatomy that is suitable for donation. A living donor doesn’t have to be a blood relative of the liver recipient but must have a compatible blood type. Recipients needing the organ may have a diagnosis of liver cirrhosis, cancer, primary sclerosing cholangitis, or any other patient who would otherwise be considered for liver transplantation.
UC San Diego Health has performed more than 3,970 organ transplants. For five consecutive years, U.S. News & World Report has ranked UC San Diego Health as the #1 adult hospital in the San Diego region. U.S. News & World Report also ranks UC San Diego Health 24th in the nation for gastroenterology and gastrointestinal surgery for 2015-2016.
To learn more about liver transplantation at UC San Diego Health, please call 888-827-3587.