(upbeat music)
- One of the hardest things about our field,
I think the greatest tragedy about our field
is when we meet patients who, for whom we have a therapy,
we believe we can save their life through transplantation.
We just can't get them there
because we just don't have enough organs
or their priorities aren't high enough
to get them transplanted quickly enough.
So the obvious and best solution to that
is living donor liver transplantation.
- Some of the compelling reasons to become a living donor
stem from the fact that
this is a elective thing that you're doing for someone else.
And it's an act of kindness
and an act of love by becoming a living donor.
So that is the primary advantage for donors
is that they've felt like they've done something for someone
and seeing the recipient thrive
in the post-transplant setting
has a lot of benefits for the donors.
- Living donor liver transplantation is unique
because there's two operations happening on the same day.
The donor operation typically starts first.
We make an incision in the donor's abdomen.
We look at their liver, which is beautiful and healthy,
that's why they were selected.
And we begin the operation of dividing
that portion of the liver safely to remove the portion
that we have selected for the recipient.
Meanwhile, the recipient operation
is starting and a separate team of our surgeons
is removing that person's sick liver.
So taking their entire liver out.
The donor operation is completed, we try to time this.
So the portion of the donor's liver is being removed
as the recipient's liver is ready to be removed.
It's preserved and flushed appropriately,
and brought over to the recipient room
where it's then implanted into the recipient.
And again, both the donor and recipient
will have a smaller portion of liver than we normally would,
but because that mass is adequate
to support their metabolism and other vital functions,
we know that over two to four weeks,
both the portion left behind in the donor
and the portion in the recipient will grow
to meet their full needs
and be equivalent to normal liver mass.
Living donor's kind of a no brainer
if it can work out, right?
So you can be transplanted before you get more ill.
Living donation is an elective operation
scheduled whenever the donor and the recipient are ready.
And if you look at the outcomes of living donor
liver transplantation, from a recipient's point of view,
the outcomes are at least as good,
if actually not statistically a little better
than waiting for a deceased donor organ.
And that benefit is largely likely
because you're transplanted earlier, when you're less sick,
you can recover more quickly.
- There's no signal at this point
that there's any long-term health risks to the donors
after the donation years down the line.
And there's no signal at this point that living donors
have a higher risk of developing liver disease themselves
or any other complications, even years after the donation.
- The selection of living donors is a complex process.
Most of that process is aimed at number one,
making sure that the donor is healthy,
has no underlying liver disease themselves
that they weren't aware of or any other medical risk
that would complicate them as a surgical candidate.
We then do the evaluation to make sure
that their liver is the appropriate size
and the anatomy is such that they can donate
to their intended recipient.
- From a psychological perspective
we also attempt to make sure that the donors
are in a good state to donate.
Similarly in a financial perspective,
and they're able to get time off of work
and having a family support.
And so that is part of the evaluation process
and sometimes those aspects of the donor's life
rule them out as well.
- So fortunately, the great thing about liver donation is
there is some risk upfront
and really selecting the best people is central to our job.
But these people can recover fully
and get back to completely normal lives.
And most of our donors
are back to all their normal activities
within three to six weeks really, which is great.
Really should be about the benefit to the recipient
and donors that go in with that expectation
really have the best experience.
(upbeat music)