Liver Transplant Donor Safety

At Ahmedabad Liver Surgeons, donor safety is our first and absolute priority. Living-donor liver transplantation (LDLT) can only be ethically and safely performed when the donor undergoes a rigorous, independent evaluation to ensure their physical and psychological fitness for surgery, a genuinely voluntary decision free from coercion, and an informed understanding of the risks and recovery involved. Our transplant team adheres to the highest international standards of donor evaluation and care, with an independent donor advocate assigned to every potential living donor.

The donor evaluation process is comprehensive and multi-stage. It begins with detailed blood tests (liver function, full blood count, coagulation, metabolic panel, viral serology, blood group compatibility), followed by high-resolution CT volumetry to accurately measure the donor's total liver volume, right lobe volume, and left lateral segment volume — ensuring the donor retains an adequate future liver remnant (FLR) of at least 30–35% of their total liver volume. MRI with MRCP delineates biliary anatomy in detail, as bile duct variants (present in up to 30% of donors) critically influence surgical planning to minimise the risk of biliary complications. Hepatic vascular anatomy — arterial, portal venous, and hepatic venous — is mapped with 3D CT reconstruction. A liver biopsy is performed when imaging suggests steatosis, and psychological assessment confirms the donor's motivation, comprehension, and voluntariness.

The donor hepatectomy — right, left, or left lateral segment depending on recipient need — is performed by our most experienced surgeons using precise dissection, with zero-tolerance for the slightest uncertainty about residual liver volume or ductal anatomy. Intraoperative cholangiography guides bile duct division. Our 90-day donor mortality risk is less than 0.1% for left lateral segment and left lobe donation, and approximately 0.2–0.5% for right lobe donation — consistent with published international benchmarks. Most donors are discharged in 5–7 days and return to full activity within 4–6 weeks. Long-term data confirm that healthy liver donors have normal life expectancy and liver function. We continue to follow all our donors with periodic clinical assessment and imaging.