What is liver transplantation?

Liver transplantation, also called hepatic transplantation, is the replacement of a damaged or failing liver with a healthy liver through surgery. The most common reason for liver transplantation is cirrhosis, which can be caused by the hepatitis B or hepatitis C viruses, or alcohol abuse. People who undergo liver transplantation receive a liver through a deceased donor or a living donor.

The process for receiving a liver from a deceased donor begins with a doctor recommending a candidate to a transplant center, where a team will perform a series of tests to evaluate the candidate for transplantation. During this time, the team may perform blood and urine tests, an ultrasound of the liver, heart tests, general health exams, and a psychological evaluation. The team also will evaluate the candidate’s support system to ensure the candidate will receive care after the transplant. If the candidate has been diagnosed with alcoholism or has an addiction to drugs or tobacco, the team may ask the candidate to undergo addiction counseling.

After the tests are completed, the transplant team will meet to discuss whether the candidate is healthy enough to undergo surgery. If the candidate is fit for transplant, the patient will be assigned to a waiting list for a donor liver. Depending on the severity of the candidate’s condition, their position on the waiting list can change — people in greater need of a liver transplant will generally receive a donated liver first if one becomes available.

During a liver transplant, the surgical team will administer general anesthesia to the patient. The surgeon will make a long incision on the upper abdomen, and the damaged liver is disconnected from the blood vessels and bile ducts and removed from the recipient. The new liver is then placed inside the recipient in the same anatomical position. The duration of the procedure is situation dependent and can last between 3 hours and 12 hours.

In the case of a living donor, the surgical team first operates on the donor and removes a portion of the liver from the donor’s body; the team then places it in the recipient’s body after removing the damaged liver. Since the liver regenerates quickly, the donor will be in the hospital for 1 week to 2 weeks and will have most normal liver functions within 4 weeks to 6 weeks after surgery.

After surgery, the recipient will spend a few days in the intensive care unit and 1 week to 2 weeks in the hospital. The overall recovery period from a liver transplantation is between 6 months and 12 months with regular checkups, and the recipient will likely need to take immunosuppressive drugs for the rest of their life.

Approximately 75% of liver transplant recipients survive up to 5 years after surgery. The recipient’s body also may reject the liver or the liver disease may reoccur; in this case, a recipient would need additional treatment or another transplant.

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