During the donor’s surgery, which typically requires 8-10 hours to complete, a segment of the donor’s liver is removed through an incision that is either straight up and down or in the shape of an inverted ‘T'. In most cases, the gallbladder is also removed.
Two surgical teams perform the donor and recipient operations simultaneously, with the donor surgery beginning 2-3 hours before the recipient surgery. The donor liver is carefully divided into the right and left lobe, making sure there is no damage to the remaining section. Often, the right lobe of the liver, which is slightly larger than the left lobe and comprises about 60% of the total volume of the liver, is the portion that is transplanted. Once separated, it is transplanted immediately into the recipient. This quick delivery of the liver graft ensures that the amount of time it is without circulating blood is minimized. This in turn increases the chances that the liver graft will function optimally after transplantation. The donor’s incision is then closed with either self-absorbing sutures or staples, which are later removed during a follow-up visit.
Following surgery, most living liver transplant donors spend their first night in the surgical intensive care unit where they are closely monitored. The next day, they can be transferred to a general surgical floor with specialized nursing staff. There, donors are encouraged to get out of bed and sit in a chair the day following surgery. Walking the hospital corridor is also encouraged as soon as possible to prevent the formation of blood clots.
Most donors are in the hospital for 5-10 days and experience pain and discomfort for about 4 – 6 weeks after surgery, particularly during the first week. A living liver transplant donor needs time to rest and recover from surgery and it is recommended that 8-10 weeks be allowed for this before returning to work. Light activity is also recommended for the first two weeks after surgery and strenuous activity and heavy lifting should be avoided for about 6-8 weeks. The donor may drive within 3-4 weeks. After 1-2 weeks, the donor needs to go back to the surgeon for a follow-up visit. Lab work will be required at one month, three months, six months and then twelve months following surgery. After this, lab tests (blood and urine) will be required annually for the rest of the donor’s life.