Before you are medically approved to become a living liver donor, UPMC's transplant team will perform an extensive clinical and psychological evaluation. These assessments will ensure you can safely donate a portion of your liver and have no medical conditions or issues that would cause special risks or complications during your living-donor surgery.
As soon as you begin the liver donation process at UPMC, we'll assign you a living-donor coordinator to help you understand what to expect before, during, and after the procedure. Your coordinator will guide you through each step of your liver donation journey. The transplant team covers all aspects of preparing for your liver donation surgery, including the financial, mental, social, and physical impacts of donation.
Your Living-Donor Liver Donation Team
Throughout the living-donation process, donors will interact with a multidisciplinary team of experts, including:
- Financial coordinators — Review your insurance coverage for donation and post-donation medications. They may also be able to recommend additional coverage to help reduce your out-of-pocket expenses after donation.
- Hepatologists (liver specialists) — Diagnose, treat, and manage liver conditions.
- Living donor coordinators — Guide living donors through all phases of the donation process. The living donor coordinator is your resource for all questions and concerns about living donation.
- Nurse practitioners — Work closely with doctors, nurses, and staff to extend the care provided by doctors. Nurse practitioners participate in the care of transplant candidates, recipients of liver transplants, and living donors.
- Pharmacists — Pharmacists assist with medication management and medication education before and after donation.
- Research coordinators — Transplant nurses who coordinate and oversee patients who participate in research protocols for studies and clinical trials.
- Social workers — Help you review your social, financial, and support systems to make sure that your donation will be a successful experience. They are also available after your procedure to help you get the medicines you need and address other social concerns you may have.
- Surgeons — Perform living-donation liver surgeries at UPMC Montefiore in Pittsburgh, Pa.
This team will determine if you are a candidate for living donation.
Your Liver Donation Evaluation
After the liver recipient’s insurance approves you for pre-liver donation evaluation, you will work with your coordinator to schedule your appointments.
What happens during a liver donation evaluation?
During your pre-liver donation evaluation, you will meet with members of the transplant team and have a series of exams and tests. Your pre-liver donation evaluation will provide your transplant team with information they need to decide if liver donation is safe for you and if you are a match for your intended liver donation recipient. It will also provide you and your care partner with information about the potential risks and benefits of being a living donor.
How long does a liver donation evaluation take?
Your liver donation evaluation involves a series of exams and tests, and can take three to five days to complete.
Does my care partner need to come to my liver donation evaluation?
Your living-donor coordinator will let you know if your care partner needs to come with you to each appointment. However, your care partner must also meet with the transplant team and learn about their role before, during, and after your living-donor procedure.
Liver Donation Evaluation Tests
During your liver donation evaluation, you will have tests to check for signs of disease and see how well your heart, lungs, and other bodily systems are working.
Tests may include:
Physical and psychosocial exams for potential liver donors
- Initial history and physical exam — Ensures you have no identifiable medical problems or history.
- Psychiatry visit — Confirms you understand the potential physical and emotional changes associated with liver donation and have the appropriate social support in place.
- Social work visit — Reviews and helps plan for post-liver-donation care upon discharge from the hospital, including:
- Housing arrangements if you're traveling to Pittsburgh.
- Medications.
- Support for personal, emotional, and physical needs.
- Transportation to and from follow-up appointments.
Blood work and imaging tests for potential liver donors
- Extensive blood tests — To determine if you have any:
- Serious medical conditions, such as heart disease, that might make liver donation unsafe for you or the liver transplant recipient.
- Transmissible diseases, such as viral hepatitis.
- Liver diseases.
- Echocardiogram — Creates images using sound waves to check how well your heart and valves are functioning.
- Exercise stress test — Shows how well your heart and lungs work during exercise.
- CT scan — Creates images of your internal organs to determine the size of the portion of the liver that can be safely donated, and to make sure you have enough blood supply to your liver.
Additional tests for potential liver donors
- Pulmonary function tests — To determine how well your lungs are working.
- Liver biopsy — Uses a needle to remove a tiny portion of your liver. Specialists examine the sample of liver tissue to make sure your liver is healthy.
What Happens After My Liver Donation Evaluation?
The liver donation selection team will review your exam and test results to decide if you can safely donate a portion of your liver to your intended recipient. If you are an eligible donor and a match for your intended recipient, you will be able to schedule your surgery at a time that is convenient for you and your intended liver recipient.
If you are not a match for your intended recipient, you may be eligible to participate in a paired exchange.
Living-donor liver paired exchanges
UPMC offers living-donor liver paired exchanges.
In a paired exchange, a living donor and recipient whose blood types are incompatible are matched with another living donor and recipient who are incompatible. The living donors agree to swap, or exchange, recipients. This allows both recipients to receive a portion of a compatible liver.
Independent living-donor advocate
If cleared to donate an organ, you will be assigned an independent living-donor advocate to act on your behalf. The living-donor advocate helps ensure you are fully aware of what it means to be a living donor and understand the risks of the donation surgery.
The living-donor advocate will voice your concerns to the multidisciplinary transplant team and will determine whether your decision to donate is fully informed.
Living donor mentors
UPMC offers the opportunity for potential living donors to speak with someone who has already been a living donor. If you’d like to connect with a mentor who can share their personal experience with you, please reach out to your living-donor coordinator or living donor liaison.
Why Choose UPMC for Liver Surgery for Living Donors?
When you choose UPMC for liver surgery for living donors, you will receive:
- Access to experienced, board-certified specialists — UPMC’s liver surgeons have pioneered minimally invasive (laparoscopic) liver surgery and have performed this technique more than 250 times — making them one of the most experienced teams in the United States.
- Expert care for complex cases — Our program is one of the oldest and largest in the United States. Since the program's inception in 1981, we have performed more than 6,000 adult liver transplants, including more than 1,000 living-donor liver transplants. This experience allows us to provide the most advanced care for our living donors.
- Personalized liver care — From thorough evaluation to world-class treatment, we provide a patient-centered approach to care throughout the entire donation process. Your dedicated team will guide and support you each step of the way.
