Why Choose a Living Donor Transplant Over a Deceased Donor Transplant?
Living Donor Transplant
- Planned, elective surgery — done at the optimal time for the patient
- Shorter wait time (2–6 weeks from donor clearance)
- Fresh, healthy liver from a thoroughly evaluated donor
- Better graft quality — no preservation injury from prolonged cold storage
- Allows family to actively participate in saving a loved one's life
- Higher success rates in experienced centres
Deceased Donor Transplant
- Dependent on organ availability — unpredictable wait time
- Patient must be stable enough to wait — higher MELD scores prioritised
- Organ quality varies — some preservation injury possible
- No control over timing — surgery happens when organ becomes available
- Suitable when no appropriate living donor is available
- Still an excellent option — outcomes comparable in good centres
In India, living donor transplants account for over 80% of all liver transplants performed — making expertise in LDLT not just preferable but essential when choosing your transplant centre.
Who Can Be a Living Liver Donor?
The decision to donate part of your liver is an act of profound love and courage. At liversurgeons.com, donor safety is our absolute first priority — we will never proceed with a donor who does not meet our strict safety criteria, regardless of the urgency of the recipient's condition.
Criteria
| |
✔ Eligible |
✖ Not Eligible |
| Age |
18–55 years |
Under 18 or over 55 (assessed case by case) |
| Relationship |
First or second-degree blood relative, spouse |
Unrelated strangers (in most cases under Indian law) |
| Blood Group |
Compatible with recipient (or ABO-incompatible with special protocol) |
Incompatible without special desensitisation |
| BMI |
18–30 (healthy weight range) |
BMI over 30 — increased surgical risk |
| Liver Health |
No fatty liver, fibrosis, or liver disease on imaging |
Fatty liver, existing liver disease, or abnormal LFTs |
| General Health |
No uncontrolled diabetes, heart disease, or active cancer |
Serious systemic illness that increases surgical risk |
| Mental Health |
Psychologically evaluated and willing — fully informed consent |
Evidence of coercion or inability to give informed consent |
Even if a potential donor does not initially meet all criteria, our team will explore every option — including ABO-incompatible transplants with desensitisation protocols and dual-lobe transplants from two separate donors — to find a safe solution for the patient and family.
Indian Legal Requirement: Under the Transplantation of Human Organs and Tissues Act (THOTA) 1994, liver donation in India is legally permitted only from close relatives (spouse, parents, siblings, children, grandparents) or — with special committee approval — from individuals with a documented close emotional relationship to the recipient.
The Donor Evaluation Process
The safety and wellbeing of the donor is the cornerstone of our programme. Every potential donor undergoes a comprehensive multi-disciplinary evaluation before any surgical decision is made. This process is completely independent — the donor's interests are protected separately from the recipient's care team.
Evaluation Phase: Tests & Assessments
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Blood Tests:
Full blood count, liver function tests, kidney function, coagulation screen, blood group & cross-match, viral hepatitis screen, HIV, CMV, EBV
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Liver Imaging:
Triphasic CT scan or MRI of the liver to assess anatomy, liver volume, vascular supply, and rule out fatty liver or lesions
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Cardiac Assessment:
ECG, echocardiogram, and cardiology review to ensure cardiac fitness for major surgery
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Pulmonary Assessment:
Chest X-ray, pulmonary function tests, and anaesthesia review
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Psychological Evaluation:
Psychiatric or psychological assessment to confirm fully informed, voluntary consent and rule out coercion
-
Surgical Planning:
3D volumetric liver analysis to confirm donor liver volume is sufficient for recipient while leaving donor with adequate remnant liver
Our team takes a minimum of 2–3 weeks to complete the full donor evaluation — thorough assessment is non-negotiable. If at any stage the donor is found to be medically or psychologically unfit, the evaluation is stopped and alternative options are explored.
What Happens During Living Donor Liver Transplant Surgery?
Living donor liver transplantation involves two simultaneous surgical procedures — one for the donor and one for the recipient — carried out by Dr. Ashish George and the team in adjacent state-of-the-art operation theatres.
THE DONOR
- 60–65% of the liver (right lobe) is removed
- Remaining 35–40% liver left in place
- Surgery duration: 6–8 hours
- Hospital stay: 7–10 days
- Full recovery: 4–6 weeks
- Donor liver regenerates to ~95% original size within 8 weeks
THE RECIPIENT
- Diseased liver is completely removed
- Donor liver segment is implanted and connected
- Surgery duration: 8–12 hours
- Hospital stay: 14–21 days
- Return to normal activity: 3–6 months
- Recipient liver grows to full functional size within 6–8 weeks
The Donor Surgery in Detail
The donor undergoes a right hepatectomy — surgical removal of the right lobe of the liver, which constitutes approximately 60–65% of total liver volume. This is performed using advanced open or minimally invasive laparoscopic techniques, depending on anatomy. The procedure takes 6–8 hours. The remaining left lobe of the donor's liver is perfectly adequate to maintain normal liver function, and it begins regenerating immediately after surgery.
The Recipient Surgery in Detail
Simultaneously, the recipient's diseased liver is completely removed (hepatectomy) and the donor liver segment is implanted and connected to the recipient's blood vessels and bile duct. The new liver typically begins functioning within minutes to hours. The surgery takes 8–12 hours and is one of the most technically demanding procedures in surgery — requiring the highest level of HPB surgical expertise.
Recovery After Living Donor Liver Transplant
Recovery for the Donor
- Hospital stay: 7–10 days post-surgery
- Pain and discomfort are managed with medication — most donors experience mild to moderate discomfort, not severe pain
- Light activities can resume within 2–3 weeks
- Full return to work and normal life: 4–6 weeks for most donors
- The remaining liver regenerates to ~95% of its original size within 6–8 weeks
- Long-term studies show donors have the same life expectancy and quality of life as the general population
- Regular follow-up visits: 1 week, 1 month, 3 months, 6 months, and then annually
Recovery for the Recipient
- Liver ICU monitoring: 3–5 days immediately after surgery
- Transfer to ward when stable — total hospital stay 14–21 days
- Immunosuppressive medications are required lifelong to prevent rejection
- Light walking from week 1 — gradual increase in activity over 3–6 months
- Return to work and daily activities: typically 3–6 months post-transplant
- Diet: balanced, nutritious, low-salt — no alcohol ever again
- Lifelong follow-up with regular blood tests, FibroScan, and imaging under specialist care
