Living liver donation is a relatively new phenomenon. The first procedure was performed in 1989 with adult-to-adult donations starting in 1995. In this report I would like to explore the assessment and procedure of live liver donation, the risks and effects, and the direction it is taking medicine in the future.

The very nature of taking part of a living person's liver and implanting it into another person is cause for questions and curiosity. One might want to know what the long-term effects on a living liver donor are. Due to the recency of the procedure, data is not yet available on the long-term effects. Information so far is anecdotal in the sense there has been only one reported death and no published incidents of failing health as a consequence of living donation; there have been no formal studies we are aware of. The limited information on short-term effects suggests complications arising from the surgery are few and manageable. For the most part they are covered by insurance. Policies vary, and some may exclude this procedure as "experimental," so you'll want to check the insurance policy of the transplant recipient. (It is the recipient's polic

· If you are donating to an adult of similar or lesser size, the entire left lobe is taken.

· Half were male, and half were female.

· The procedure can be scheduled at a time convenient for both the donor and recipient.

· Most (64.1%) were between the ages of 18 and 34.

For purposes of this report, we'll assume the left lobe is to be donated. The donor is placed on his or her left side (the liver is on the right side of the body) with the right arm raised above the head. A large incision is made along the flank and access to the liver is gained by using rib spreaders. The veins, bile ducts, and arteries of the left lobe are clamped and cut. The left lobe is removed, flushed, and placed in a cold preservative solution. It is transported to the operating room of the recipient for transplantation. Note that, with a living donor, some parts of the liver such as veins and arteries are not sufficiently large for transplantation. (This is not an issue with cadaveric donations where preserving veins and arteries in the donor are not important.) Consequently, a portion of the sapheous vein in your leg is also removed and used to connect the donated liver to the recipient. You are then sewn up. Because of the large number of blood vessels in the liver and the large exposed area created, the surgery can take several hours. The procedure as a whole takes five to eight hours. You are placed in the Intensive Care Unit of the hospital overnight for observation. Assuming all goes well, you will be moved to your hospital room where you will stay for about a week. You will be able to return to work in about six weeks-a bit longer if your work is physically demanding.

In a University of Chicago study (Grewal, H.P., et al.), 100 living related liver transplants were reviewed to assess the surgical complications. The findings reveal there were no donor deaths. There were 14 "major" complications, the most common (half) being bile duct injury or leaks. Complications were more common in left lateral resections than left lateral grafts. Minor complications occurred in 20% of the cases, with obstruction of the intestine and urinary tract infection being the most common (four cases each). The study also showed the incidence of complications was smaller for donors, whose surgery was in the latter half of the group, suggesting the likelihood of problems diminishes as the transplant teams gain experience. It also suggests you, as a potential donor, will want to know the experience level of your transplant team.

· 58.6% were blood type O, 32.9% were type A, 8.6% type B, and none

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Approximate Word count = 1739
Approximate Pages = 7 (250 words per page double spaced)