Partial Liver Transplant Question

[MarkB44]

I have two questions about partial liver transplants:

1) Is there a "threshold" MELD score at which partial transplants are not performed? What is makes a good candidate for a partial transplant?

2) Are there statistics as far as the mortality rate for donors and or general risk information? Can donors live normal lives afterward, or are they restricted in any way? (including becoming pregnant etc).

Thanks for your help.

[Thomas D Schiano, MD]

we cite a mortality rate of about 1-2% for the procedure.  You can check the literature from the A2ALL study group that has complied a lot of information on this. Adult patients should not be too sick to receive a live donor--in NY the threshold is not to do it above MELD 25. We expect donors should have a mormal life and now have data for about 10 years.  someone who is healthy, the same blood type and the same size or larger than the recipient may be a good candidate.

[snapperqueen]

hi,
I will tell you as a liver donor to my husband, i am perfectly fine except the big mercedes scar in my stomach, however doctor advice if I want to get pregnant,,maybe wait for a little bit  maybe a year or two to be safe.  i am perfectly fine thank God.
you can ask me anytime for some info and my experience.

[gilmane]

For a guide to the  Living Donor process see:  
http://www.transplant.bc.ca/pre_livingliver.htm
It is a good overview of the entire process and explains the benefits for the recipient  and risks to the donor. It describes the entire process (select "Information guide for potential live liver donors" )
Also read "FAQ" on same site.
To  Babyblueyes910, This is major surgery for the donor, unless the recipient has demonstrated clear ability to stay off alcohol and  is likely to remain off it after the transplant, I would be hesitant about it.

[Babyblueyes910]

My sister continues to tell me about a partial transplant and like for me to be the donor.  I have not however found much info on effectiveness.  I will share that she is an alcoholic and has to have fluids drained regularly therefore may not be a candidate. Can you tell me how safe it is for me and for her and if this is something that we may want to check into.

thank you so much.

[Thomas D Schiano, MD]

yes.  the donor has potential riosks.  in addition, in parts of the country there is an inequity on the waiting list.  in NY, patients need MELD scores of 30 to get transplanted while in the midwest and south it may be closer to 20.  thus, live donor liver transplants are not needed in certianm parts of the country.  In addition, only about 20% of recipients have potential suitable donors.

[MarkB44]

Thanks for the information.

I am surprised by the low numbers of surgeries each year (looks like 350 or so) despite the  15,000 + awaiting transplants. I understand everyone on the list is not in critical condition, but I'd expect a larger number of partial transplants. Is there a reason the numbers haven't grown?

Is it because of the nature of the surgery itself and the risks involved?

thanks