Examination and surgery
Do you want to donate part of your liver while living? Read about the examinations you will undergo at the hospital and how the surgery and recovery process works.
Examination at the hospital
Have you signed up to donate part of your liver to someone else? If so, the transplant hospital will examine step-by-step whether you are suitable as a donor. We call this a screening.
Your health always comes first. The doctors want to know if your own liver is functioning well enough and if you can handle it mentally. That is why you will have a number of consultations and medical examinations.
Consultation
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. They will look with you at whether you are mentally and emotionally strong enough and help you with everything that comes your way.
For example, you will discuss:
- How do you feel about liver donation?
- How do you deal with 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 costs reimbursed?
- What about work and leave?
There is also an additional conversation with a medical psychologist or psychiatrist.
Medical examinations
This is followed by medical examinations to determine if you are physically healthy enough to donate part of your liver. These may vary per hospital. Examinations include:
- Measuring your blood pressure, height, and weight.
- Blood tests: liver function, blood clotting, viruses such as hepatitis or HIV.
- Heart tracing (ECG) and an X-ray of your heart and lungs.
- CT scan for 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 anesthesiologist. They will assess whether your body can handle anesthesia.
Who is not suitable as a donor?
Your health always comes first. Sometimes you cannot become a donor, for example:
- if your own liver is not functioning 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. You will go to the hospital one day before the surgery. What can you expect?
The surgery lasts between 6 and 8 hours. Is the gallbladder being removed? If so, 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. This happens very rarely. 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 operation.
Risks of the surgery
Mild problems that occur more frequently
- The wound does not heal properly or becomes infected
- Pneumonia
- Incisional hernia
- Scar tissue or adhesions in the abdomen causing impaired bowel function
- Pain
Major complications (rare)
- Bile may leak from the liver
- Bile duct may become narrowed
- 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 due to the surgery
In the donor, the remaining part of the liver may 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 yourself urgently need a new liver. You would 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 may need to arrange childcare or household assistance.
Back home, what now?
After the surgery, you will go to a special ward where doctors and nurses will monitor you closely following the anesthesia and surgery.
You may continue to experience pain for a few days after the surgery. Your liver will grow back 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.
Temporary help with housework
When you are back home, you may need some help with housework 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 reimbursement for the extra costs you incur.
Back to work
It may take a while before you can work full-time again. This depends on your recovery and the type of work.
Check-ups and aftercare
After the surgery, you will have a check-up with the surgeon. You will also have regular check-ups after that. A bit more often in the first year. The hospital will let you know who will perform the check-ups and how often this is necessary.
Do you have any 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 does not go ahead in the end.
- Your health insurer pays the medical costs, such as screening, surgery, and check-ups. You do not pay anything from your excess (deductible) for donation.
- Sometimes you have to spend extra money, such as on parking costs or for help with housework. There is an expense reimbursement for this via the NTS
- It is also possible that you will have a temporary loss of income. There is also a reimbursement for this.