Many people with advanced liver disease in need of a transplant choose a living-donor liver transplant for one simple reason. The waiting time can be far shorter.

Here's what you need to consider when choosing liver transplant options.

Why people choose living-donor liver transplant

For a living-donor liver transplant, a healthy person chooses to safely donate part of their liver. In a matter of months, their liver grows back (regenerates).

A living-donor liver transplant offers many benefits, including:

  • Earlier treatment — Receive a transplant before your liver disease worsens.

  • Less waiting — Surgery may happen sooner than waiting for a deceased-donor liver.

  • More planning — The transplant team can schedule surgery instead of waiting for a donor organ to become available.

Your other option is to have the transplant center add your name to the United Network for Organ Sharing (UNOS) waiting list.

How long is the liver waiting list?

How long you wait for a deceased-donor liver depends on many factors, including your blood type and your Model for End-Stage Liver Disease (MELD) score.

The MELD score is a series of blood tests that measure how your liver works. The higher your score, the more likely you are to receive a liver from a deceased donor when an organ becomes available.

Getting a deceased-donor liver can take time — from days to years. According to the American Liver Foundation, more than 9,000 people in the United States are waiting for a liver transplant.

While you wait, your liver disease may continue to progress. You may get a liver before your condition worsens, or you may not. This is why many people opt to go the living-donor route.

How does liver disease affect your daily life before a transplant?

There is a large spectrum of liver disease. Some people have physical symptoms of advanced liver disease. These symptoms include ascites, esophageal varices, and hepatic encephalopathy. Other people with advanced liver disease do not have physical symptoms. They might not realize that they have advanced liver disease until they are diagnosed. 

As liver disease progresses, everyday activities may become more difficult. You may have less energy for work, family, hobbies, or exercise. These changes can also affect your friends, family members, and caregivers or care partners.

Your loved ones can support you when you experience:

  • Fatigue that makes daily tasks harder.

  • Frequent medical appointments and testing.

  • Physical symptoms that limit activity.

  • Uncertainty while waiting for a transplant.

Choosing Liver Transplant Options

Choosing liver transplant options is a personal decision, but you won't have to make it alone.

Your transplant team will help you decide if a living donor transplant or a deceased donor transplant best fits your needs. They'll take into consideration:

  • Whether a living donor is available.

  • Your health and liver disease stage.

Your social support system, like your family, friends, and neighbors, are a key part of your transplant journey.

Your transplant team is here to help both you and your loved ones understand the transplant process and your transplant options.

Your loved ones can be part of the transplant decision-making process.

A liver transplant affects more than you. Your loved ones should also understand the medical aspects of living-donor and deceased-donor liver transplants and the support you’ll need during your recovery.

Your transplant team is there to offer you and your family support during transplant decisions.

You and your family may have many questions about living-donor liver transplants. Together, you can brainstorm questions to talk through with the team.

To help you prepare for your conversation with your transplant team and make an informed choice, consider discussing the following topics with your family:

  • Benefits and risks of a living-donor transplant.

  • Donor eligibility and evaluation.

  • Surgery and follow-up care.

  • Recovery for both you and your donor, and the support you'll need.

Coping with Liver Disease Decisions and the Emotions They Bring

Living with liver disease affects more than your physical health. Symptoms, frequent appointments, and uncertainty can also impact your emotional well-being — not to mention your daily routine.

For some people, those emotions carry over to making important decisions about treatment. This may include whether a liver transplant is the best option.

How do you cope emotionally with transplant decisions?

In general, the liver transplant process can be emotional. You may feel hopeful one day and overwhelmed the next.

A living-donor liver transplant can increase the emotions you feel. You may worry about asking someone to become a living donor. You may feel guilty about accepting such a generous gift.

These feelings are common. Many transplant programs offer support throughout the process, including:

  • Counseling

  • Education

  • Social workers

  • Support groups

  • Transplant coordinators

Emotional factors in choosing liver transplant

Choosing a liver transplant can bring many emotions.

Before surgery

It's normal to have mixed feelings before surgery. You may feel hopeful about the future but also worried about the transplant or recovery.

If a family member or friend is your living donor, you may feel grateful while also wondering how the donation will affect them.

After surgery

Recovery can also bring many emotions. You may feel relieved that the surgery is over but also feel tired, frustrated, or anxious as you heal.

These feelings are common. If they don't improve or if they affect your daily life, talk with your transplant team.

Preparing mentally for a living-donor liver transplant can help

Getting ready for a living-donor liver transplant means preparing your mind as well as your body.

Before surgery

Learn about the transplant process and ask questions. Talk with your loved ones about what to expect. Before surgery, make a plan for rides, meals, childcare, and other help you may need while you recover.

After surgery

Give yourself time to heal. Recovery is different for everyone, and some days will be easier than others. Follow your transplant team's instructions, accept help from family and friends, and focus on getting a little stronger each day.

Transplant journey lifestyle impact

Living-donor liver transplant lifestyle considerations go beyond the surgery itself.

Before surgery

Planning ahead can make recovery easier. Most people need time away from work or school after surgery. You will also need help with everyday tasks, such as driving, childcare, or household chores.

After surgery

Recovery takes time. You'll have regular follow-up appointments and take medicine to protect your new liver. Your transplant team will monitor you closely to make sure your body is not rejecting, or attacking and damaging, your new liver.

As you regain your strength, you'll slowly return to your normal activities. Your transplant team will also help you learn how to eat well and stay active as you recover.