General Physical Risks
Specific Physical Risks
- Complications caused by anesthesia.
- Excessive bleeding that may require blood transfusions and the risks involved with the use of blood or blood products.
- Cardiovascular complications, such as heart attack, arrhythmia, cardiovascular collapse, and hypertension.
- Injury to other organs in the abdomen, fluid collection, and intra-abdominal adhesions.
- Blood clots in the legs that can break free and move to the lungs (pulmonary embolism).
- Digestive tract problems, such as constipation, bloating, nausea, ileus (slow or absent bowel activity), bowel obstruction or perforation.
- Painful surgical wound or discomfort at the incision site that can develop into chronic pain.
- Infection (such as urinary tract infection) or other complications caused by catheterization, fever, pneumonia, or wound infection.
- Living donor could develop liver failure after the donation surgery. This could require an emergency liver transplant for the donor or lead to death. This is a very rare complication and occurs in approximately 2 out of every 1000 (0.2%) living liver donor surgeries.
Specific risks associated with liver surgery and particularly a partial hepatectomy include:
- Bile leaks are the most common complication and occur 5-15% of the time. Most bile leaks get better without requiring additional surgery and can be treated with an endoscopic procedure. that places a plastic drain (stent) to decompress the area or a soft tube that diverts the leaking bile and allows the area to heal. Sometimes the bile is drained outside the body via a tube into a bag that is removed once the leak stops.
- Bile duct strictures (narrowing) can also occur after surgery, but are much less common. This can usually be treated by endoscopic placement of a stent that dilates the narrow area in the bile duct.
- The donor’s liver may not be suitable for transplantation and this may even be decided in the operating room if the doctor assesses the donor liver and determines that it cannot be transplanted. The donor’s liver may also have abnormalities that could not be detected through diagnostic tests before the procedure. The transplantation will then be aborted.
Based on national statistics, the risk of having some type of complication, either major or minor, is approximately 15‐40%. Most of these problems are minor and will get better on their own and rarely require a procedure or corrective surgery.
There are potential temporary or permanent psychosocial risks associated with liver donation. The donor’s quality of life may be affected by donation due to insomnia, anxiety, depression, preoccupation with overall health or liver health, suicidal thoughts, body image issues, post-traumatic stress disorder (PTSD), or feelings of guilt or emotional distress if the recipient experiences complications, recurrence of their disease, or even death.
If the donor is feeling anxious, overwhelmed, or emotionally distressed in any way, please reach out to the organ transplant team for support and assistance. Psychologists and other experts will be available for support should the donor or family members require it.