During living donor liver transplantation, surgeons remove a portion of a healthy living person's liver for transplantation into a recipient. This procedure is made possible by the liver's unique ability to regenerate: the partial liver in both the donor and recipient grow and remodel to form complete, functioning organs.
Because of the scarcity of donor organs, living donors are an important part of the care we provide. The Living Donor Liver Transplant Program at NewYork-Presbyterian Hospital is one of the largest and most experienced living donor liver programs in North America:
Our program achieves excellent outcomes for donors and recipients which exceed national and expected outcomes for liver transplantation. According to the most recent SRTR data, our recipients have a 97.1% one-year survival rate after transplantation and a three-year survival of 93.3%. Additionally, nearly all donors have reported feeling very satisfied or satisfied with donating.
A living donor offers the possibility of earlier transplantation to those in need. More than 18,000 people are waiting for liver transplantation, but just over 6,000 deceased donor livers become available each year. By improving access to transplantation, particularly in regions such as New York that have longer waiting lists, living donor liver transplantation may reduce a patient's risk of dying by 20% to 40%.
Recipients of livers from living donors generally fare better than those who receive livers from deceased donors because they are in optimal health at the time of transplant, and the tissue they receive is usually from a young, healthy donor.
The program at NewYork-Presbyterian/Columbia University Medical Center is the only one in the country to perform living donor liver transplantation via laparoscopy. We have used this approach to perform living donor liver transplantation from an adult to a child, and also from an adult to another adult or teenage recipient.
The benefits of the laparoscopic approach for the donor include:
A healthy family member, spouse, or friend may volunteer to donate a portion of his or her liver. As much as 60% of an adult liver may be donated to an adult recipient, and 20% to 25% may be donated to a child.
The general criteria for a living liver donor include:
Medical evaluation of living donors takes place at the state-of-the-art Comprehensive Transplant Outpatient Center located at NewYork-Presbyterian/Columbia. This evaluation includes:
While achieving excellent clinical outcomes is vital, we view caring for the donor as central to our mission.
A wide range of educational and support services are available for both donors and recipients. The Hospital's dedicated Independent Donor Advocate Team carefully evaluates potential organ donors and advocates on their behalf to ensure that donation would cause them no harm.
The National Living Donor Assistance Center (NLDAC), established by the U.S. Health Resources and Services Administration (HRSA), provides financial assistance for travel, lodging, and meals to those who want to donate an organ and would otherwise not be able to afford these expenses.
NewYork-Presbyterian/Columbia is the only institution in New York City participating in the national multicenter NIH-funded Adult to Adult Living Donor Liver Transplant Cohort Study (A2ALL), which is focusing on the factors influencing the outcomes of living donor liver transplants for both donors and recipients. Researchers are comparing outcomes of this procedure with those for patients who receive livers from deceased donors.
Patients with fulminant liver failure – acute liver failure usually due to a medication overdose or virus – traditionally have had limited options: intensive medical care that enables rapid recovery of their own liver or liver transplantation. In a newer procedure, auxiliary liver transplantation, surgeons attach a portion of a healthy donor's liver to a portion of a recipient's diseased liver.
The donor liver supports the patient during recovery, clearing toxins and preventing brain injury. After the patient's own "native" liver recovers, the donor liver usually withers. Whereas liver transplantation requires patients to take immunosuppressant medications for the remainder of their lives, auxiliary transplants do not.
NewYork-Presbyterian Hospital was one of the first institutions to perform this procedure, which now accounts for a substantial proportion of liver transplants in children today.
Center for Liver Disease and Transplantation
Phone: 877-LIVER-MD (877-548-3763)
Center for Liver Disease and Transplantation
Phone: 646-962-LIVER (646-962-5483)