A Look Inside Penn Medicine’s Living Liver Donor Program
The science behind the liver, one of the body’s most important organs with the remarkable ability to regenerate, is fascinating for transplant development.
Liver transplant is a life-saving surgery for people with end-stage liver disease. With more than 15,000 patients on the waiting list to receive a liver transplant and a critical shortage of deceased donor livers, an alternative is desperately needed.
And for many, that alternative – one that can save more lives – can be found at Penn Medicine’s Living Donor Program. Living liver donation allows a healthy adult to donate a portion of their liver to a patient in need.
To learn more about the science behind living donor transplantation and why it’s effective, we consulted Penn Medicine transplant surgeon and Chief of the Division of Transplantation at Penn, Kim M. Olthoff, MD, along with Living Liver Donor Coordinator, Linda Wood, RN, BSN. Here, they explain more about the living donor transplant process and what to do if you’re considering becoming a donor.
1. How does one become a liver donor? Why might they decide to?
There are several life situations that could lead someone to consider living liver donation. The first is knowing someone suffering from liver disease who is eligible to receive a living donor transplant. Most often people who consider being a living liver donor are immediate family members, but donors can also be other relatives or close friends. The desire to help someone and save a life is often the main driving force to becoming a living donor.
2. Why might the recipients be in need of a liver?
A person suffering from end-stage liver disease that has progressed to cirrhosis may become ill enough to need a transplant. Various conditions can cause liver disease: Hepatitis B or C, past alcohol use, autoimmune diseases, metabolic syndrome and obesity, genetic disorders and many more. Over time, the liver disease may worsen and start to cause serious symptoms of end-stage liver disease that warrant consideration for transplantation. In addition, patients with cirrhosis can develop liver cancer, one of the main indications for liver transplantation.
3. What are the benefits of a living liver versus a deceased one?
While patients receiving deceased donor livers have excellent outcomes, they must reach quite a high “disease severity score”, called MELD, before getting an offer. This is because there are not enough deceased donor livers available for all the patients waiting. The higher the score, the sicker the patient and the higher they are on the list.
By having a living donor liver transplant, patients in need of a new liver do not need to wait as long (depending on the time it takes to find a suitable donor) and become as sick. They can receive their transplant earlier in the disease process before other organs are severely affected. This may allow for a smoother procedure, quicker recovery and improved surgical outcomes.
5. Does the liver “regrow”, so to speak?
The liver has the amazing ability to replace what is removed. So, if we remove the right lobe of the liver from a donor, the remaining left lobe will grow rapidly until it reaches close to its starting size. Most of this occurs within the first few months after surgery. Similarly, the transplanted lobe will grow in the recipient to meet their needs.
6. How does the living donor program at Penn Medicine differ from other programs?
The Penn Transplant team is the most experienced living liver donor program in the region. Our multidisciplinary team takes comprehensive care of the transplant recipient, as well as the liver donor. Our physicians perform groundbreaking research to drive improvements in patient outcomes after transplantation, liver regeneration in the transplant setting, minimization of immunosuppression medications and long-term quality of life for donors.
Research published by our team has also shown that recipients and donors have the greatest post-transplant benefits when the surgery is performed at an experienced living donor transplant center – Penn Transplant Institute has the most experienced living donor program in the region.
7. If someone would like to become a living donor, what steps should they take next?
The first step to becoming a living donor is simple: Learn more about the donation process. Visit the Penn Living Transplant website or call 215-662-6200 and ask for Linda Wood, our Living Liver Donor Coordinator.
This interview has been edited for length.This is a paid partnership between Penn Medicine and Philadelphia Magazine's City/Studio