AI Summary Having a potential living donor is linked to a higher chance of receiving a transplant earlier in the disease course, shorter median waiting times, and lower illness and death on the waiting list, with the largest gains for people with moderate to severe frailty, shorter stature (under about 5 feet 3 inches), or a MELD-Na score under 20.
Medically reviewed.
In living donor liver transplant (LDLT), a healthy living person gives a portion of their liver to someone whose liver is failing or who has liver cancer confined to the liver. The donor may be a family member, a friend, or a person the recipient does not know. Unlike a deceased-donor transplant, which depends on an organ becoming available after a donor has died, LDLT can be planned ahead of time, so the recipient may wait less.
Having a potential living donor is linked to receiving a transplant earlier in the disease course, with shorter waits and a lower risk of dying or being removed from the waiting list. The liver can regrow after a large part is removed, which makes this type of transplant possible.
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Living Donor Basics
In living donor liver transplant (LDLT), surgeons take a portion of a healthy living person's liver and transplant it into someone whose own liver has failed or who has liver cancer confined to the liver. The liver can regrow lost tissue, even after surgeons remove up to 70% of it. Because LDLT does not wait for a deceased-donor organ, it can happen on a planned timeline. That matters most for people who could get sicker, or be removed from the waiting list, before a liver becomes available. Exact steps vary by transplant center. This is the general order.
| Step | Stage | What Happens |
|---|---|---|
| Step 1 | Referral and Transplant Evaluation | The recipient is evaluated at a liver transplant center by hepatologists, transplant surgeons, social workers, and other specialists. The evaluation combines lab tests, imaging, and a psychosocial review, and it can take a few days to several weeks. |
| Step 2 | Finding a Potential Donor | A family member, a friend, or a person who does not know the recipient steps forward. The transplant team checks that the donor is healthy and that the donor's blood type and liver fit the recipient. |
| Step 3 | Matching and Planning | Imaging compares the donor's liver with the recipient's body size and anatomy so the graft fits. A liver that is too small can leave the recipient weak, and one that is too large will not settle comfortably. The team then plans the surgery ahead of time. |
| Step 4 | Surgery | Surgeons remove a portion of the donor's liver. They also remove the recipient's diseased liver and replace it with the donor's portion under general anesthesia. The recipient's transplant surgery usually takes 6 to 12 hours. |
| Step 5 | Recovery and Follow-Up | The recipient's hospital stay is typically 1 to 3 weeks, and full recovery often takes 3 to 6 months. Monitoring is lifelong and includes anti-rejection medicine and regular lab tests. |
Donor eligibility
Transplant centers screen every potential donor to protect the donor's health and to confirm the liver portion will work for the recipient. Each center sets its own detailed criteria.
Glossary
These terms come up often during a living donor transplant. Knowing them helps you follow conversations with your transplant team.
Why living donation helps
A living donor can help many candidates, and some groups gain more than others.
Having a potential living donor raises a candidate's chance of receiving a transplant. This holds for people with MASH cirrhosis and for people with other causes of liver disease. LDLT is linked to shorter median waiting times and lower illness and death while on the waiting list.
Because LDLT does not wait for a deceased-donor organ, people can be transplanted earlier, before complications build up. This matters most for older, frailer patients and those with other health conditions who could get worse quickly while they wait.
Research points to three groups that benefit especially: people with moderate to severe frailty, people of shorter stature (under about 160 cm, or 5 feet 3 inches), and people with a MELD-Na score under 20. These candidates are at high risk of dropping off the waiting list, and a living donor helps most.
Data over several decades show a survival benefit and improved access to transplant with LDLT, including lower waiting-list death rates.
Risks and recovery
Living donor surgery is a major operation for both people. Recipient risks and recovery are better documented than donor risks, so ask the transplant center for its own donor data.
Both the donor and the recipient should have their own clear conversation with the transplant team before deciding. Protocols vary by center, and this page does not replace that conversation.
Getting started
Living donation can be directed to someone you know or offered to someone you do not. The next step is the same: talk with a transplant center.
Many living donors give to a family member or friend. The transplant team checks blood type, liver size, and anatomy to see if the donor is a match.
Some donors give to a recipient they do not know. This is called altruistic donation. Ask the transplant center how it handles donors who are not connected to a specific recipient.
If you are thinking about donating, contact the transplant center caring for your intended recipient. The team will explain the evaluation, answer your questions, and make sure your decision is your own.
Ask your transplant team whether a living donor could be an option for you. Share this page with family or friends who have asked how they can help. Your team will also tell you how a donor fits into the waiting list.
Getting ready
Preparation helps the transplant run smoothly for the recipient, the donor, and the people supporting them.
Keep medical records, imaging reports, and referral letters together in one folder. Bring them to every appointment.
Work with your dietitian and physical therapist to hold a stable, healthy weight. Steady weight helps the team match the liver portion to your body size.
Attend every lab draw and visit. Fresh results keep your MELD score accurate. Stay hydrated and arrive on time.
Plan for travel, time off work, insurance approvals, and who will help at home. Choose a friend or family member to drive you, carry documents, and speak up for you.
Because living donor surgery is planned, the date is set in advance. If you are also on the deceased-donor waiting list, keep your phone charged, keep a packed bag ready, and tell your coordinator about any change in contact details.
Coping with the process
A living donor transplant brings hope and worry together. These feelings are common and do not mean something is wrong with your case.
Common questions
In living donor liver transplant (LDLT), a healthy living person donates a portion of their liver to a recipient. In a deceased-donor transplant, the liver comes from a person who has died, so timing depends on when an organ becomes available and on waiting-list priority. LDLT can be planned ahead of time, which can shorten the recipient's wait. Research over several decades shows a survival benefit and better access to transplant with LDLT, including lower waiting-list death rates and transplant earlier in the disease course. Your transplant team can tell you whether either option fits your situation.
Yes, it can. Having a potential living donor is linked to a higher chance of receiving a transplant and to receiving it earlier in the disease course. LDLT is also linked to shorter median waiting times and lower illness and death while on the waiting list. This holds for people with MASH cirrhosis and for people with other liver diseases. The donor must still be evaluated and approved first. Ask your transplant team how to start that conversation.
Some groups gain more than others. These include people with moderate to severe frailty, people of shorter stature (under about 160 cm, or 5 feet 3 inches), and people with a MELD-Na score under 20. People who are older or have other health conditions may get worse quickly while waiting for a deceased-donor liver, so a living donor can be especially helpful for them. A living donor can help people with many kinds of liver disease. Your team decides what is right for you.
A potential donor must be healthy, and the team checks that the donor's blood type and liver fit the recipient. Imaging measures liver size and anatomy, so the portion will fit the recipient's body. A psychosocial review looks at the donor's support system and readiness, and the decision to donate must be free and informed. Donors can be family members or friends. Some give to someone they do not know, which is called altruistic donation. Each center sets its own detailed rules, so the transplant team gives the final answer.
Yes. The liver can regrow lost tissue, even after surgeons remove up to 70% of it. This is what allows a portion of a donor's liver to work in the recipient while the donor keeps enough liver to recover. Regrowth is not instant and scarring can slow it in people with liver damage, so the transplant team follows both the donor and the recipient with lab tests and visits. Ask your center how long it expects recovery to take.
Living donor surgery is major surgery. For recipients, bile duct complications are a known concern. They occur in about 15% to 30% of living donor transplants, compared with about 10% to 15% of deceased-donor transplants. They include narrowing of the bile duct connection (strictures), bile leaks, and stones, and they need prompt treatment. Recipients also take anti-rejection medicine, which lowers the immune response and raises the risk of infection and some cancers. Risks to donors vary by center, so ask the transplant center for its own donor outcome data and follow-up plan.
For the recipient, the transplant operation usually takes 6 to 12 hours. The hospital stay is typically 1 to 3 weeks, and full recovery often takes 3 to 6 months, with a gradual return to daily activities. Monitoring is lifelong. It includes anti-rejection medicine, regular lab tests, and checks for complications. Recovery time can be longer if complications occur. Donor recovery times vary by center, so ask the team what to expect for the donor.
Medical disclaimer: LiverDirectory provides educational information and a directory of providers. It does not provide medical advice, diagnosis, or treatment. Always consult a licensed physician regarding any medical condition.
