If you know someone with liver cancer, it’s possible that a liver transplant is their best hope for a cure. And — provided you’re a match and you both meet eligibility criteria — you can provide a lifesaving living-donor liver transplant.
In a living-donor liver transplant, someone donates part of their liver to a recipient. UPMC considers living-donor liver transplants a lifesaving first treatment option for people with liver cancer and end-stage liver disease.
To qualify for a living-donor liver transplant, both the donor and the recipient must meet certain eligibility requirements. Learn more about who qualifies for a living-donor liver transplant for liver cancer.
Who Is Eligible to Receive a Living-Donor Liver Transplant for Liver Cancer?
To qualify to receive a living-liver transplant for liver cancer, the recipient must have cancer in their liver only. If the cancer is metastatic and has spread to other parts of the body, they can’t receive a transplant.
The biggest reason for that is immunosuppressive drugs. The recipient takes immunosuppressive drugs to prevent organ rejection. If the cancer has spread beyond the liver, those drugs can weaken the body’s ability to fight the cancer.
If the cancer is in the liver only, the diseased liver gets removed. Then, the donated partial liver takes its place. This can save the recipient’s life.
The doctors will run tests, including blood work and imaging studies. This will determine whether the recipient’s cancer has spread. If it hasn’t, then they qualify for a transplant.
Differences between living donation and deceased donation criteria for liver cancer
The eligibility criteria for living-donor liver transplant for liver cancer is wider than the eligibility criteria for deceased-donor liver transplant because of the following:
- Deceased-donor transplants can’t have tumors that have grown beyond a certain size. The recipient also must have a high enough Model for End-Stage Liver Disease (MELD) score. The MELD score estimates the chance of surviving the disease for the next three months. Patients with a MELD score under 15 don’t join the national waiting list for a deceased-donor transplant.
- For living-donor liver transplant, the donor has chosen to donate to the recipient. That means even people whose MELD scores wouldn’t qualify for a deceased-donor transplant can qualify for a living-donor transplant. But their cancer must have stayed in their liver only and can’t have spread elsewhere.
Can I Become a Living-Liver Donor?
If you want to donate your liver, your blood type must have compatibility with the recipient’s. You also must meet the other general criteria for living-liver donation, which include:
- Your age is between 18 and 60 years old.
- You’re in good physical and mental health.
- You have a body mass index (BMI) of less than or equal to 32.
- You’re in generally good health, with no history of:
- Active malignant cancers.
- HIV.
- Liver disease, including cirrhosis, hepatitis, and/or steatosis (fatty liver).
- Diabetes.
- Pulmonary hypertension.
- Significant diseases of the heart, lungs, or kidneys.
- You have an unselfish desire to help save someone’s life.
- You’re not engaging in active drug or substance use.
Before determining if someone is a candidate, they’ll go through various tests, including:
- Blood work.
- Chest x-rays, an EKG, and a stress test (depending on donor age).
- A CT scan and MRI.
Evaluation team members will include a transplant surgeon, transplant hepatologist, social worker, and independent living donor advocate. They’ll also include a pharmacist, behavioral team, finance, nutrition, and a nurse coordinator.
Living-donor liver exchange
You may not match with your intended living-donor liver transplant recipient. If this is the case, a living-donor liver exchange is an option.
In a living-donor liver exchange, a donor who isn’t a suitable match for their chosen recipient can become a living donor for someone else on the waiting list. Their recipient is then paired with another living donor who’s a more compatible match.
A living-donor liver exchange can save two lives.
Can a Living-Donor Liver Transplant Cure Liver Cancer?
Yes, a living-donor liver transplant is a potentially lifesaving cure for liver cancer that hasn’t spread beyond the liver. It’s an especially important treatment option for people who might not otherwise qualify to receive a liver from a deceased donor.
With living donation, recipients don’t have to wait for a donor organ to become available. That means they can potentially undergo the transplant before the cancer spreads.
In general, living-donor liver transplants lead to shorter wait times, faster recoveries, and better outcomes.
The liver also can regenerate. The donor’s remaining liver and the recipient’s new liver will regenerate within a few months of the transplant.
Why Choose UPMC for Living-Donor Liver Transplant?
UPMC is a pioneer in living-donor liver transplants. The UPMC Liver Transplant Program is one of the oldest and largest liver transplant programs in the United States. We lead the nation in pediatric and adult living-donor liver transplants.
Our experience allows us to take on complex cases, including patients who aren’t candidates elsewhere. We provide an option for patients with liver cancer or low MELD scores.
UPMC has developed transplant protocols for several advanced liver cancers, including:
- Hepatocellular carcinoma (HCC).
- Hilar cholangiocarcinoma.
- Intrahepatic cholangiocarcinoma or mixed cholangio/hepatocellular carcinoma.
- Unresectable metastatic colorectal cancer.
- Unresectable neuroendocrine tumor.
To learn more about the UPMC Liver Transplant Program or to schedule an appointment, visit our website.
Editor's Note: This article was originally published on , and was last reviewed on .