Transplant Living Donor Evaluation

Donor Criteria

  • Should be above 21 years of age and less than 55 years old
  • Same blood group or blood group “O”
  • Donor should ideally be related to the recipient (immediate family members)
  • In the event the family is not suitable for donation for medical reasons, emotionally related donors are permissible after review by the hospital ethics committee
  • Should not have significant medical problem
  • Hepatitis B and C and HIV should be negative
  • Adequate liver volume and suitable anatomy of the liver
  • Significant fatty liver would be a contraindication
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    Suitable blood group for Recipient
    Your blood type should be compatible, even if it is not the same as, the organ donor.
    Blood Group
     

    Donor Pre-Transplant Evaluation Assessment

    Donor will be evaluated by a physician for fitness for surgery, and if necessary by a cardiologist as well. Occasionally, liver biopsy may be required for those with fatty liver to quantify the amount of fat. Psychiatric assessment is also required to ensure that the donor is mentally prepared for the operation and understands the implication of the surgery. The work-up* includes:

  • Complete blood test
  • Chest X-ray and ECG
  • CT scan of the liver
  • Surgeon’s consultation
  • MeVis** pictures
  • Respiratory assessment
  • Cardiac assessment
  • Psychiatric assessment
  • Legal assessment (lawyer, transplant assessment by the coordinator and Ethics meeting)
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    *This pre-transplant assessment is aimed at ensuring the best chances for a successful organ transplant. The more matches there are, the more likely your body will accept the new organ. As a donor, you may also need to undergo x-rays, scans and other screenings as determined by your doctor.

    **We employ state-of-the-art technology from a German company called MeVis Distant Services (MDS). The data from the CT scan of the donor is uploaded to MDS where a team of highly specialised technicians and a radiologist interpret the data and send back detailed information and color pictures depicting the vascular anatomy, the volume and the suitability of the proposed liver graft. It is a precise and highly individual diagnostic tool which enables the surgeon to perform the donor operation with utmost safety and confidence. The AALC is currently the only transplant centre using this technology routinely in Southeast Asia.
     

    Donor Pre-Transplant Evaluation Process

    The evaluation process is designed to prove that you do indeed have a normal, healthy liver and that it would be safe for you to donate. Liver transplant is a major surgery and you will certainly have pain after surgery and require pain relievers. In addition with surgery of this nature you are at risk for some other complications involving the surgical procedure. A detailed workup process will help us identify any potential problems and also help the surgeons decide on their technique for your surgery.
     

    Prior authorisation from the hospitals’ Transplant Ethics Committee (TEC) is required before any living donor organ transplant can proceed. The TEC has to be satisfied that two major professional and ethical concerns are adequately addressed. Firstly, the donor must thoroughly understand the nature and consequences of the medical procedures and give his or her full informed consent. Secondly, there must not be any form of coercion or financial inducement to donate the organ. This applies to all living donor organ transplants, regardless of whether the donor and recipient are related or not. The TEC is completely independent of AALC. As such AALC cannot be held responsible for approval for transplant. ONLY after the approval is obtained from the TEC, can AALC plan for the transplant. No explanation will be given by the TEC to cases that have not been approved by them.
     

     

    Advice For Liver Donor

  • You are saving a patient by donating part of your liver and this is a magnanimous life saving gesture.
  • Liver donation is voluntary and should not be made out of coercion. You should never feel any pressure at any time.
  • At no point it is too late to change your mind even if you have gone through the entire evaluation process.
  • The risk of death from the operation to remove part of your liver is estimated at 0.3% to 0.5% or 3 to 5 in 1000 liver donations. Risk increases in a less experienced centre.
  • The risk of wound infection and other minor complications is about 15%
  • There is an abdominal scar after the operation. Your gallbladder is removed as part of the procedure without causing any long term consequences.
  • You can live a normal lifestyle and do not have to take any long term medication. You can have children. Donating part of your liver does not reduce your lifespan and does not increase the risk of developing liver disease or failure.
  • You will be admitted to the hospital the day before the surgery, and usually hopitalised for one week.
  • You will be seen in the transplant clinic weekly for 2 weeks after your discharge and able to return home if your blood test and ultrasound liver results are satisfactory.
  • You are advise to repeat blood test 1 month, 3 months and 6 months after your discharge.