Be a liver donor…

Liver transplantation is a surgery performed by liver transplant surgeons or hepatobiliary surgeons to remove the diseased liver of an individual and replace it with a healthy liver. The liver being used for replacement can either be from a healthy living donor or from a deceased brain-dead patient. This procedure is performed as a last effort in chronic liver diseases which were not essentially treated/controlled with other treatment modalities and in case of acute liver failure like with drug-associated liver toxicity. Usually, the liver donors are relatives of individuals requiring the liver. This gives a psychological boost to both the individuals. Also, live liver transplantation can be done in an elective manner by optimising the donor and recipient. However, this procedure has its risk factors associated.

Risk Factors for donors:Liver donation is essentially hepatectomy (removing a part of the liver). This is a major surgery and has its own set of risk factors and likelihood of complications. Some of them pertaining donors are as follows:

1. MortalityThough more and more advancement has taken place in liver transplantation surgeries with setting up of dedicated transplant centres, donors still have associated mortality risk of 0.5-1%.

2. Biliary complicationsThe most common complications in donors of liver are associated development of biliary complications. Bile is greenish fluid secreted by the liver and stored in gall bladder. It helps in lipid digestion in the small intestine. Biliary complications are reported in up to 40% of all living donor transplants. These can be in form of a leak from biliary duct. Most cases are managed intra-operatively and resolve with time. Other form of biliary complication is biliary stricture which requires dilatation by ERCP or other surgical intervention at a later stage.

3. InfectionLiver dissection is a long and major surgical procedure with the area being operated lying deep in the abdomen. Also, the risk of blood and bile being collected persists. With prolonged time of procedure, the risk of developing infection increases.

4. BleedingBleeding is a particular risk factor/complication associated with liver surgery firstly because of the surgical field involving vascular structures and as the essential clotting factors, required to maintain haemostasis in the blood, are secreted by the liver itself. Resection of a part of the liver affects the status of clotting factors produced and may manifest as intra-operative bleeding which require vigorous management and may also require blood and clotting factors transfusion.

5. EmbolismUndergoing a major surgery runs a risk of developing embolism which can lodge in the periphery like legs and can also travel to and block the arteries supplying the brain and cause neurological deficit. There’s also a risk of developing a blockage in the lungs due to pulmonary embolism and can be life-threatening.

6. PainLiver donation is a open abdominal surgery involving large part of the abdomen. Though pain relief is administered during and after the surgery, donors tend to have significant postoperative pain. It usually takes a week for the pain to decrease after the surgery with some amount of discomfort persisting for up to 4-6 weeks.

All donors are rigorously screened and worked up in the pre-anaesthetic evaluation and optimized so that the risks of developing these risks are reduced. However being a major surgery and involving the liver, the threat of developing risks are always imminent.

To know more about your specific condition, please visit a Hepatologist in a trusted hospital close to you.