Evaluation and surgery
Do you want to donate part of your liver while living? Read about the medical tests you will undergo at the hospital, how the surgery works, and how the recovery proceeds.
Evaluation at the hospital
Have you registered to give part of your liver to someone else? If so, the transplant hospital will check step by step whether you are a suitable donor. We call this a screening.
Your health always comes first. The doctors want to know if your own liver functions well enough and whether you can handle it mentally. Therefore, you will have a number of interviews and medical examinations.
Interview
You will speak with a medical specialist, nurse practitioner, or a liver donation coordinator. They will explain the surgery, the risks, the recovery, and everything involved in liver donation.
Questions about your mental health
You will also have a conversation with a social worker. Together with you, they will assess whether you are mentally and emotionally strong enough and help you process everything coming your way.
For example, you will discuss:
- How do you feel about liver donation?
- How do you handle gratitude or expectations from the patient?
- What is the impact on your family or your work?
The social worker also helps you with practical matters:
- How do you arrange help after the surgery?
- How do you get reimbursed for expenses?
- How do work and leave arrangements apply?
There will also be an additional consultation with a medical psychologist or psychiatrist.
Medical examinations
Next follow medical examinations to determine whether you are physically healthy enough to give part of your liver. These may vary per hospital. Examinations include:
- Measuring your blood pressure, height and weight.
- Blood test: liver function, blood clotting, viruses such as hepatitis or the AIDS virus.
- Electrocardiogram (ECG) and an X-ray of your heart and lungs.
- CT scan to get a clear image of the liver to accurately estimate how large the piece of liver for the recipient can be.
- MRI scan of blood vessels and bile ducts near the liver.
After the examination:
- The surgeon reviews all examinations and assesses whether your liver is suitable for donation.
- The surgeon explains what the surgery entails and what the risks are.
- You will speak with the anaesthesiologist. They assess whether your body can handle general anaesthesia.
Who is not suitable as a donor?
Your health always comes first. Sometimes you cannot become a donor, for example:
- if your own liver does not function well enough
- if you have psychological issues
The surgery
It might feel strange: before the surgery you are healthy, and afterwards you are a patient for a while. One day before the surgery you go to the hospital. What lies ahead of you?
The surgery takes between 6 and 8 hours. Is the gallbladder being removed? Then this will be started during the surgery. The surgeon checks the bile ducts for this. If they are structured differently than expected, the donation might not be able to proceed. That happens very occasionally. Do the bile ducts and the liver look good? Then a part of the liver is removed.
The team that removed the piece of liver consults with the team performing the surgery on the recipient about starting that surgery.
Risks of the surgery
Mild problems that occur more frequently
- The wound does not heal properly or becomes infected
- Pneumonia
- Herniation of scar tissue under the skin
- Scars or adhesions in the abdomen that impair bowel function
- Pain
Major complications (rare)
- Bile leakage from the liver
- Narrowing of the bile duct
- Significant blood loss during surgery or postoperative bleeding
- Abscess (pus-filled cavity)
- Thrombosis or pulmonary embolism
- Inflammation of the bile ducts
- Damage to blood vessels, nerves, and organs near the liver
- There is a very small risk of death as a result of the surgery
In the donor, the remaining part of the liver can sometimes be too small, causing the liver to function less effectively. In very rare cases, the remaining part of your liver functions so poorly that you urgently need a new liver yourself. You will then be placed on the high-urgency waiting list for a new liver.
After the surgery, you will need time to recover. Keep in mind that you will be unable to work for a while and will need to arrange childcare or household help, for example.
Back home, what now?
After the surgery, you will go to a special unit where doctors and nurses will monitor you closely after the anesthesia and surgery.
You may experience pain for several days after the surgery. Your liver will regenerate within a few weeks to months. Due to the removal of your gallbladder, you may initially experience diarrhea and need to be careful with fatty foods. However, these symptoms usually disappear after a while.
Most donors stay in the hospital for about 5 to 8 days.
A temporary housekeeper
Once you are back home, you might need help with housekeeping for a while. See if family or friends can help.
Other options:
- Request domestic help through the municipality (Wmo). This is sometimes possible.
- Hire help yourself through a company
Make use of the living donation expense allowance for the extra costs you incur.
Back to work
It may take a while before you can return to work fully. This depends on your recovery and the type of work.
Follow-up and aftercare
After the surgery, you will have a follow-up appointment with the surgeon. You will also continue to have regular check-ups afterwards. Slightly more often in the first year. The hospital will let you know who will conduct the check-ups and how often this is necessary.
Do you have questions or complaints after returning home? Or do you need psychological support? Then contact your contact person at the hospital.
Costs and reimbursements
Many of the expenses you incur as a donor are reimbursed, even if the donation ultimately does not go ahead.
- Your health insurer pays the medical costs, such as the screening, surgery, and check-ups. You do not pay anything from your own risk (deductible) for the donation.
- Sometimes you have to spend extra money, such as on parking costs or for housekeeping help. An expense allowance via the NTS is available for this
- It is also possible that you will have a temporary decrease in income. There is also a reimbursement for this.