Where do donor livers come from?

Donor livers are obtained from individuals who have suffered catastrophic brain injuries or brain hemorrhage. These individuals have been declared dead due to the lack of function of the brain. When such an individual is identified, consent for organ removal is obtained from their next of kin. Information about the donor is entered into a national computer network and local, regional and national lists of potential recipients for the donor organs are obtained by the local organ procurement organization. The group that maintains the national computerized transplant network is called the United Network for Organ Sharing (UNOS). This organization has the government contract to match donors with patients who require transplantation. Within each local area, there are organ procurement organizations who handle the identification and removal of transplantable organs from brain-dead individuals and also ensure that these organs are placed according to criteria established by UNOS.

Do donor and recipient have to be matched by tissue type, sex, age, etc.?

No. For liver transplants, the only requirements are that the recipient and the donor need to be of a compatible size and compatible blood type. No other matching is necessary. It is possible at present to take parts of larger livers and place them into smaller children. These procedures are called reduced-size transplants. Livers grow and these transplanted livers develop normally with the growing child.

What happens if there are two suitable recipients for a donated liver?

The national waiting list has been devised to give priority to the sickest patient. The present system includes a medical status for all potential liver transplant recipients. This system is a four-tiered status system with Status One patients being the most critically ill and status Four the least in need of transplantation. When a donor liver is available, it is preferentially given to the higher status patient. Within a given status, patients are prioritized based on their waiting time. Many other factors may influence the decision about who gets a particular donor liver. These include donor size, blood type, and the possibility of performing a reduced size transplant (transplanting only a part of the liver).

How can I donate my organs?

If you wish to be an organ donor, carry an organ donor card and place an organ donor sticker on your medical identification card. Most importantly, you must discuss the decision about organ donation with your family members. At the time of organ donation, you will be unable to communicate your wishes and your family will be asked to provide for consent. Unless you have discussed it with your family, it will be more difficult for them to make the decision about donating your organs.