From the Guidelines
Yes, a parent can donate a liver to their adult child through a procedure called living donor liver transplantation. The liver has remarkable regenerative capabilities, allowing surgeons to remove a portion of the donor's liver (typically the right lobe for adult recipients) and transplant it into the recipient 1. After donation, both the donor's and recipient's liver portions will grow to normal size within a few weeks to months. For this to be possible, the parent must be in good health, have a compatible blood type, and pass extensive medical and psychological evaluations. The evaluation process includes blood tests, imaging studies, and consultations with specialists to ensure the parent is physically and mentally prepared for donation.
Some key points to consider in living donor liver transplantation include:
- The donor's right liver lobe, which comprises segments V to VIII, is typically used for adult recipients 1.
- The procedure requires meticulous dissection of the right hepatic artery, right portal vein, right bile duct, and right suprahepatic vein.
- Recovery for the donor typically takes 2-3 months, with most donors returning to normal activities within 8-12 weeks.
- The success rate for living donor liver transplants is excellent, with one-year survival rates exceeding 90% 1.
- This procedure is particularly valuable because it allows the transplant to occur before the recipient becomes critically ill and can be scheduled at an optimal time for both donor and recipient, rather than waiting for a deceased donor organ to become available.
It's worth noting that living donor liver transplantation is a well-established procedure, and its outcomes have been extensively studied 1. While there are risks associated with the procedure, the benefits of living donor liver transplantation, including improved survival rates and quality of life, make it a viable option for many patients.
From the Research
Liver Donation from Parent to Adult Child
- The possibility of a parent donating a liver to their adult child is a complex issue that involves various medical, psychological, and ethical considerations 2, 3.
- Live donor liver transplantation is a treatment option for patients in need of orthotopic liver transplantation, and parents are often the ones seeking donation to save their child from irreversible liver failure 2.
- However, parental live liver donation poses unique challenges due to the biological and emotional relationships with the child, and special consideration should be given to the informed consent and the decision-making process, psychological health, and presence of substance use when weighing the risk versus protective factors for donors 2.
Medical Considerations
- The long-term outcomes for pediatric recipients from live liver donors are excellent, but the outcomes for adult recipients may vary depending on several factors, including the donor's health and the recipient's condition 4, 5.
- The liver can be split into two grafts, one for a child and one for an adult, which can increase the supply of liver grafts and reduce waiting list mortality 4.
- However, donor selection, technical expertise, and logistics are crucial factors for successful outcomes after split liver transplantation 4.
Evaluation of Potential Donors
- Accurate pretransplant evaluation of a potential donor is essential in preventing postoperative liver failure and optimizing safety 6.
- Imaging modalities, such as Doppler ultrasound, computerized tomography, and magnetic resonance angiography, are used to evaluate vascular anatomy, and calculation of liver volume and assessment of steatosis are performed by enhanced and nonenhanced CT 6.
- The main reasons for exclusion from donation include steatosis, inadequate remnant volume, small-for-size graft, and psychosocial problems 6.