A liver transplant can be a treatment option for primary and metastatic liver cancers, and is often the best chance for a cure. A living-donor liver transplant may offer an even better chance.

With a living-donor liver transplant, you can potentially get a new organ faster. This may improve your survival odds.

The criteria for living-donor liver transplant as a treatment are also less strict than the criteria for deceased-donor transplants. You may be eligible for a living-donor liver transplant even if they aren't eligible for a deceased-donor liver transplant.

Because of these factors, living-donor liver transplant is a promising treatment for liver cancer.

Learn more about living-donor liver transplant for cancer treatment. Discover the liver cancer transplant eligibility criteria and how the evaluation process works.

Can Living-Donor Liver Transplant Cure Liver Cancer?

Yes, living-donor liver transplants can cure liver cancer. It offers better chances for survival than liver resection, another surgical option for liver cancer.

Research has reported strong survival and low recurrence rates after living-donor liver transplant for liver cancer.

A 2025 study in Surgical Endoscopy analyzed the outcomes of people with hepatocellular carcinoma (HCC), the most common cancer that starts in the liver, who underwent a liver transplant.

The study reported that people who underwent living-donor liver transplant had a better survival rate and lower recurrence rate than those who underwent deceased-donor liver transplant. The five-year survival rate for living-donor liver transplant was 82%. People who underwent living-donor liver transplant also had a much shorter time to surgery.

Those results confirm living-donor liver transplant's value as a lifesaving treatment for liver cancer, the authors wrote.

Who Qualifies for Living-Donor Liver Transplant for Liver Cancer?

Liver cancer patients can qualify for a living-donor transplant if their cancer is only in (localized) the liver. That means that the cancer hasn't metastasized (spread) to other parts of the body.

If the cancer has spread, they're not eligible. Transplant recipients have to use immunosuppressive drugs to prevent organ rejection. Those drugs make it harder for the immune system to fight the cancer in the rest of the body.

Along with having localized cancer, you also have to locate a living donor. Your donor can be a family member, friend, co-worker, neighbor, or even someone you don't know.

A living donor must also meet certain criteria, including:

  • They must be between 18 and 60 years old.
  • They must be in good general health, with no history of cancer, HIV, diabetes, heart or liver disease.
  • They must have a body mass index (BMI) below 32.
  • They must have an unselfish desire to help others.

What to expect during a liver transplant or living donor evaluation

Both liver cancer patients and potential donors have to go through a thorough evaluation process. This evaluation includes medical tests as well as psychological screenings. The goal is to ensure you're both medically ready for a transplant.

Evaluation tests include:

  • Blood work.
  • Colonoscopy.
  • Electrocardiogram (EKG).
  • Imaging scans (x-ray, CT, MRI, and/or ultrasound).
  • Age-appropriate cancer screenings.
  • Psychological screening.
  • Stress echocardiogram (echo).

During this process, both the donor and recipient will meet the transplant team members. These team members will help conduct the tests and evaluate the donors and recipients.

What if a living donor and their recipient aren't a match?

If the donor you find isn't a match, a living-donor liver exchange is an option. In a living-donor exchange, your donor agrees to donate to another recipient. In return, you receive an organ from another living donor.

How Does a Living-Donor Liver Transplant Work?

During living-donor liver transplant, doctors remove a portion of the donor's healthy liver and transplant it into the recipient. Living-donor liver transplant is possible because the liver has a special ability to regenerate. After about 8 to 10 weeks, the liver regrows to full size and function in both the donor and recipient.

In general, people who receive living-donor liver transplants have shorter recovery times and better outcomes than deceased-donor liver transplants.

What are the benefits of living-donor liver transplant vs. a deceased-donor liver transplant for liver cancer?

Both living-donor and deceased-donor liver transplants offer a potential cure for liver cancer. But living-donor liver transplant has a couple of added benefits compared to deceased-donor liver transplant:

  • Living-donor liver transplant can allow people to get a new liver sooner.
  • More cancer patients can be eligible for a living-donor liver transplant.

How does living-donor liver transplant allow cancer patients to get a new liver sooner?

According to the American Liver Foundation, there are more than 14,000 people on the national waitlist for a liver transplant. Waiting for a deceased-donor transplant can take years — time that a cancer patient may not have.

On the other hand, if you find a compatible living donor, your transplant can take place sooner. You may be able to undergo surgery before your cancer worsens or spreads. This increases your survival odds.

How do the criteria for living-donor liver transplant differ from the criteria for deceased-donor liver transplants for liver cancer?

The criteria for living-donor liver transplant as a liver cancer treatment are more flexible than the criteria for deceased-donor liver transplants.

For deceased-donor transplants, your tumors can't exceed a certain size. They also typically need a high model for end-stage liver disease (MELD) score.

The MELD score estimates a person's likelihood of surviving in the next three months. MELD scores range from 6 to 40.

People with higher MELD scores appear higher on the national transplant waiting list and are more likely to receive a deceased-donor transplant. Those with MELD scores of 15 or under often aren't listed for deceased-donor transplants. But many people may be sicker than their MELD scores indicate.

Access to living-donor liver transplant depends on finding an eligible donor, not a MELD score. For a living-donor transplant, the donor is directing that their liver go to a certain recipient.

Even if you don't qualify for a deceased-donor transplant, you can still be eligible for a living-donor liver transplant. You and your donor just have to meet the other criteria for living-donor liver transplant for liver cancer.

What Are the Risks for Living-Liver Donors and Recipients?

Like any major surgery, a living-donor liver transplant carries risks. These include:

  • Allergic reaction to anesthesia.
  • Behavioral health complications (such as anxiety or depression).
  • Bile duct leakage.
  • Bleeding.
  • Blood clots.
  • Damage to other organs or tissues.
  • Death.
  • Infection.
  • Organ rejection.
  • Pneumonia.

These risks are what make the living-donor liver transplant evaluation process so important. The benefits of the surgery must outweigh the risks to you and your donor.

Why Choose UPMC for Living-Donor Liver Transplant?

The UPMC Liver Transplant Program is a pioneer in living-donor liver transplant.

Our surgeons have performed more than 1,000 living-donor liver transplant procedures. Our experience allows us to take on more complex cases, including patients who may not be candidates for transplants elsewhere.

We provide living-donor liver transplants for several types of liver cancer, including:

  • Hepatocellular carcinoma (HCC).
  • Hilar cholangiocarcinoma.
  • Intrahepatic cholangiocarcinoma or mixed cholangio/hepatocellular carcinoma.
  • Unresectable metastatic colorectal cancer.
  • Unresectable neuroendocrine tumor.

For more information about the living-donor transplant program at UPMC, visit our website.