Why you should consider going abroad for liver transplants...

• No Waitlists
• Donors available via Planet Hospital's Global Donor pairing program
• Affordable (and potentially reimbursable by some healthcare plans)
• World Class surgeons
  
  

The Costs

Cost of a living donor liver transplant ranges from $75,000-$95,000 depending on the amount of medications used and the destination.

Cadaveric livers are sometimes available depending on blood type and the cost is $90,000-$110,000.

What is a Liver Donor Live Transplant (LDLT) ?

Until 1989, if you needed a liver transplant, it had to come from a cadaver, now thanks to amazing advancements in surgery and science, a living person can donate a portion of their liver because the liver can regenerate. It started initially with parents donating a lobe of their liver to their children but now adult to adult donation is possible.

However, many hospitals will not accept non-related or even closely related patients. This means that if you have a friend who is willing and compatible but not a blood relative you might not be eligible to get the surgery in your country, but we can help you get the surgery you need in other countries (please note to prevent controversies, the location will be revealed to bona fide patients only).

Live Donors

If you want to be a liver donor, we salute you for your generosity and kindness and courage but you should read this and the UNOS website to understand all the risks.

• Blood and tissue typing, to make sure there is compatibility with the recipient.
• The overall health of your liver
• You are healthy enough to withstand major surgery and recover completely.
• You have a healthy liver.
  
  

As a potential donor, you will be tested for the following:

• Type A can donate to types A and AB.
• Type B can donate to types B and AB.
• Type AB can donate to type AB.
• Type O can donate to types A, B, AB, and O.
  
  

In a liver transplant the following compatibility is acceptable:

Not all transplant surgeons require it but it is best to get done prior to any surgical decision. Tissue typing is a group of procedures that determines the type of histocompatibility antigens on a person's cells or tissues. This procedure is typically used prior to transplantation of tissues or organs.

The success of transplantation is greatly dependent on the degree of histocompatibility (identity) between the donor and recipient, which is determined by the HLA complex.

When the donor and recipient have a low degree of histocompatibility, the organ is said to be mismatched, and the recipient mounts an immune response against the donor antigen.

By laboratory testing, the degree of antigenic similarity between the donor and the recipient and the degree of preexisting recipient sensitization to donor antigens (and therefore preformed antibodies) can be determined. This is known as cross-matching.

Tissue type

Crossmatching is a further testing of antigen compatibility. In this test, white blood cells from you are mixed with blood from the recipient.

If the white blood cells are attacked and die, then the crossmatch is "positive," and therefore you are not a match as the recipient's immune system would turn on the donated organ.

If the crossmatch is negative, you are compatible with the recipient.

Crossmatching

Also as a donor you must meet the following criteria:

• No heart, renal, or liver problems or abnormalities.
  
  
• No history of deep vein thrombosis or history of bleeding problems.
  
  
• Negative for Hepatitis B and C and for HIV.
  
  
• No history of diabetes.
  
  
• No prior liver surgery.
  
  
• No alcoholism or frequent and heavy alcohol intake.

• No history of cancer.
  
  
• No psychiatric illness under treatment.
  
  
• Your height and weight compared to the recipient is "appropriate."
  
  
• There may be an age limit. One center places it at 45, another at 60. Check with your transplant team.

The Surgery

The donor is given general anesthesia and is aligned on the left side of their body (as the liver is on the right). An incision is made and the ribs are spread to gain access to the liver

The veins, bile ducts, and arteries of the left lobe are clamped and cut. The left lobe is removed, flushed, and placed in a cold preservative solution. It is then transported to the operating room of the recipient for transplantation.  Usually the recipient is NOT in the same Operating room as the recipient.  Since some parts of the liver such as arteries and veins are not large enough for transportation, a portion of the sapheous vein, located in the leg is also removed so that it can be used for grafting onto the donor liver and the recipient.

The donor is then sewn up and placed in intensive care for observation and infection control and then shifted to a hospital for 7-10 days before being discharged.
 

• Pain. Usually managed with medications.  The pain will subside after 5-7 days.
• Infection. Incision wounds sometimes get infected which results in scarring, herniation and an overall delay in the healing process.  Antibiotics are used to treat any infections.
• Pneumonia. Patients will be required to breathe deeply and cough frequently to prevent pheumonia.  This act is quite painful post surgery but is very necessary.
• Blood clotting. As with any surgery, blood clots in the legs can be a problem. To prevent clotting and related complications, circulation in the legs is aided at first by special stockings. The stockings are hooked up to a machine which inflates the stockings periodically, applying pressure to your legs and improving circulation. Once you are able, you will be encouraged to walk around, which also stimulates circulation.
  
  

Crossmatching Commons risks and side effects for the donor are as follows:

In a University of Chicago study (Grewal, H.P., et al.), 100 living related liver transplants were reviewed to assess the surgical complications. The findings reveal there were no donor deaths.

There were 14 "major" complications, the most common (half) being bile duct injury or leaks. Complications were more common in left lateral resections than left lateral grafts. Minor complications occurred in 20% of the cases, with obstruction of the intestine and urinary tract infection being the most common (four cases each).

The study also showed the incidence of complications was smaller for donors whose surgery was in the latter half of the group, suggesting the likelihood of problems diminishes as the transplant teams gain experience. It also suggests you, as a potential donor, will want to know the experience level of your transplant team.

Additional studies of the impact on living liver donors are desperately needed.

• Allergic reaction to anesthesia. Part of the screening process includes identifying allergies you may have. In the event of an allergic reaction to anesthesia, the anesthestist will take immediate corrective action.
• Injury to bile duct or other organs. The surgical process of removing a portion of the liver creates the risk a bile duct will be damaged. There could also be damage to surrounding organs and tissues, such as the spleen or bowel. In such cases, follow-up surgery will be needed to repair the injury.
• Death. It happens. Fortunately, it is rare. Known deaths include one in North Carolina, one in New York, and some in Europe, but reporting has been sketchy. News articles have quantified the risk at 0.5% to 1.0%.
  
  

No matter what your liver surgery circumstance might be, we have a network of surgeons around the globe ready to assist you.