The potential donor needs to understand all aspects of the donation process, as well as the risks involved in being a living donor.
Informed consent for living donor
The consent process includes:
- The donor must be willing to donate without any force or pressure.
- Disclosure that the donor is not receiving any price (monetary or material gain) for the donation. The donor can be reimbursed for travel expenses and a working donor may be compensated for income lost.
- A psychological assessment of the potential donor.
- An evaluation of the donor’s ability to fully understand the donation process will be conducted.
- A full understanding from the donor that they will not be receiving any medical advantages from the donation procedure. The donor also needs to be aware that their gallbladder will be removed as part of the operative procedure, with no long-term consequences.
- Disclosure that the transplant centre will report living donor follow-up information when needed for at least 2 years after the liver transplantation.
Potential medical risks for donor
- Risk of death is around 3 – 5 in 1,000 liver donations.
- Possibility of organ failure and the need for a future organ transplant for the donor.
- Risk of wound infection and other slight complications for the donor.
- Heart problems, stroke, and blood clot formation in the legs or lungs.
- Bile leakage can occur in about 5 – 15% of patients. In the majority of cases this problem resolves without the need for surgery.
- Risk of a bile duct being damaged, which could also lead to damage of neighbouring tissues and organs including the spleen and bowel. Follow-up surgery is then needed to repair the injury.
- Incisional hernia which is the projection of an organ through the wall that normally contains it. This could be due to thinning or stretching of scar tissue that develops after surgery.
- Allergic reactions to anaesthesia.
- Hyperbilirubinemia or jaundice which is caused by high levels of bilirubin in the blood, therefore resulting in yellowish eyes and skin.
- Small bowel obstruction (blockage), inflammation (swelling) of the pancreas, and kidney failure.
- Thrombosis of the portal vein – the blood vessel that moves blood from gastrointestinal tract and spleen to the liver.
- Pulmonary embolism which occurs when a blood vessel in the lung is blocked by blood clots that may have travelled to the lungs from another body part.
- Intra-abdominal bleeding.
- Pleural effusion which refers to the abnormal build-up of fluid in the pleural cavity, the fluid-filled space that surrounds the lungs.
- Gastric perforation (tear), gastric outlet obstruction.
- Surgical scars, pain, tiredness, bloating and nausea.