Whole or partial??

[JA970354]

What determines if they use a partial or whole donor liver is used for transplant?.

[AyrshireK]

Body size of the recipient mostly. If they are smaller in stature they can normally manage for a short time with a partial/split liver which will then grow to full size and this allows the remaining portion of liver to be used in a child patient. Only the very best livers can be split. A huge burly bloke for example couldn't accept a split liver as it would be too small to carry out the functions required for a bigger person.

Hope that make some sense.

Katie

[JA970354 in reply to AyrshireK]

Thanks,that makes sense.So I was trying to figure out If a living donor can donate.or would I need a would I need complete liver.I guess it depends on how much damage.

[AyrshireK in reply to JA970354]

They tell you at transplant assessment what type of liver you'd be able to accept - some people need a liver from a brain deceased donor, some can accept from a cardiac deceased donor, some can have split and some can have a live donation (this is a big process though which can put a donor at some degree of risk too & surgeons will always prefer a cadaveric liver rather than putting a healthy person through a major operation). Those who are able to have a live donation have to be on the normal waiting list for a donated liver from a deceased donor.

When my hubby was assessed he was told he was eligible for all 4 types though in the end he was delisted after 10 months due to an improvement in his bloods which took him out of the qualification criteria.

Katie

[JA970354 in reply to AyrshireK]

Oh that must have been great news for him.Thank you.you cleared up a lot of questions I had.

[Porphyriamaniac in reply to AyrshireK]

I find it fascinating and puzzling to think about..for instance where do they split it? Is there not only one portal vein? If so how do they reconnect it into in two people? 🤔Then there is the fact that it actually grows back to full size and function after it has been cut into two, the human body and the liver in particular are amazing aren't they!? X

[JA970354 in reply to Porphyriamaniac]

Me too I'm not on a list yet,it is confusing if I can get a sibling to donate a part of theirs.I guess I'LL find out more when the time comes

[BSA-3 in reply to Porphyriamaniac]

Yes , absolutely amazing!

[AyrshireK]

If you are interested in reading up a bit about live donation the Scottish Liver Transplant (which hubby was under) have an information page and online accessible leaflet which you can have a read at. I believe Edinburgh and the SLTU were the first of the UK centres to pioneer live liver transplantation. nhslothian.scot.nhs.uk/Serv...

As regards the point on the single portal vein etc. they do have to 'construct' new 'pipework' when plumbing in a split liver.

Katie

p.s. Hubbies removal from the list was a bit upsetting at the time as sadly his symptoms have never improved (only his bloods) so he felt like the light at the end of the tunnel regarding a 'new life' had be snuffed out, perhaps we had a rose tinted glasses view of transplant at the time. Since he was delisted we have tried to make the most of every good day and write off the bad. He continues to be well monitored and if his need for transplant re-emerges we hope he gets his chance. It's not great being too unwell to live life to the full but not classed as ill enough to get the chance of improvement. As we've seen on here all to often not everyone gets the 'golden ticket' from transplant.

[LiamLucy in reply to AyrshireK]

Thank you so much for posting this link. Very thorough and informative in easy to understand language. I will pray your husband's health will improve and that he has may more "good" days than "bad".

[Porphyriamaniac]

A fountain of knowledge along with sound, informative advice as always Katie ☺ your husband has had a terrible time of it but he is a lucky man in that he's got you supporting him and fighting his corner, you are a credit to him and a credit to this forum and all of us that use it too. X

[JA970354 in reply to Porphyriamaniac]

Amen to that and this site!!

[BSA-3 in reply to JA970354]

Ditto...

[Danisleigh]

My son had his transplant just over 4 weeks ago and as he is 16 and quite slight he could have a right lobe or a whole liver from a small adult. A larger man would obviously need whole liver. My son received a right lobe in the end and the left lobe went to a baby.

[Febeli57 in reply to Danisleigh]

Hello danis I'm a grown adult my height is174 c and weigh 149 pounds would I qualify for a right lobe or is your son smaller?

[Danisleigh in reply to Febeli57]

He is 175cms but only weighed about 110lbs.

[Febeli57 in reply to Danisleigh]

Ok thanx for the fast replay hope he's doing fine

[Danisleigh in reply to Febeli57]

Thanks yes he is doing really well. Are you waiting for transplant? If so I hope your wait isn't too long.

[Febeli57 in reply to Danisleigh]

Yes I have my first talk with the transplantation team on Tuesday nervous as hell I think there will be a lot of tests first? If I'm even eligible for a transplant I hope ? Questions over questions

[Danisleigh in reply to Febeli57]

My son had his assessment at he children's hospital so not sure if it's the same but we had appointments all week mon-fri. He had a kidney function test, a dental exam, heart ECG, blood tests and meetings with people like the transplant coordintors, anaesthetists, surgeons and psychologists. we had been told that he would definitely be listed as long as they didn't find any health issues as he had a tumour which was right on the size limit to be eligible for transplant but at the end of the week we signed the paperwork and he was active on the list by Friday afternoon. We were quite lucky he waited less than 3 weeks but I guess he was quite high priority given his situation. I hope your assessment goes well and fingers crossed you get the outcome you want x

[Hidden]

Anyone had transplant , offered or heard of a transplant for anyone with cancer ( i know the arguments ) i'm wondering if anywhere in the world such may/has been/has considered (desperate)

Bal1

[Danisleigh in reply to Hidden]

My son was transplanted last month with a suspected hepatocellular carcinoma.

[AyrshireK in reply to Hidden]

Yes we have members on the site who have had transplant due to HCC - however, in the UK there are strict guidelines as to the number of tumours and size of tumours when it comes to transplant. It there are too many or they are too big then sadly they won't consider transplant owing to the major risk of seeding the cancer elsewhere through the body via the transplant procedure.

They might try shrinking the tumours first or liver resection if appropriate.

Current UK guidelines state - A lesion must be seen on 2 forms of imaging with typical characteristics to count as HCC.

The size of a HCC will be the larger of the two if there is a discrepancy. The listing criteria

at present are:

Single tumour<5cm diameter

or

Up to 5 tumours all < 3cm

or

Single tumour between 5 and 7cm with no evidence of progression (<20% volume

increase) over a six month period. Locoregional therapy or chemotherapy may be

given at this time. AFP <1000 U/l

Hope that helps,

Katie

[Hayls48]

I had a split liver transplant I got the right lobe and portal vein and a baby had the left lobe. My recovery was good, due to disease I was quite a petite adult. I weighed about 62kgs and am 5’2” tall. My surgeon told me the baby recovered well as did I.

At transplant assessment I was given a book an all the different types of transplant options etc. The decision was made by the surgeons on what type of transplant I was given. I understand a lot depends on the donor organ also. As said above only the best livers are split.

Hope this helps xx

[Hidden]

Danisleigh , hello so pleased to read that and i hope he's on the mend , can you give some details ? i.e. where in the world are you from, what hospital etc.? (my e-mail is [e-mail] if you would feel more comfortable exchanging information ) PLEASE let me know ,

many thanks Barry

[Danisleigh in reply to Hidden]

Hi Barry,

We in the U.K. In Leicestershire and he was transplanted at the QE Birmingham. He is technically still under the children's hospital being 16 but they split the liver between my son and a baby so the surgeons at the QE operated on my son and the baby was transplanted at the children's. He was born with a liver disease and in 2015 they found a lesion on his liver which they diagnosed as regenerative tissue but in a follow up last year the lesion had increased so they did another MRI and they found the density had also changed and they were concerned enough to order a biopsy. The biopsy wasn't 100% conclusive but they felt 90-95% sure that the lesion had started turning into cancer in one area. The lesion was 6.5cms in length so if the cancer continued he would have been unable to be listed so they were keen to get it done. We are still waiting for the reports back on the tumour to confirm it was definely a HCC.

Hope that helps, feel free to ask any more questions you have x