Living Liver Donor Program

Since 1990, over 800 living liver donor transplants have been performed at the University Health Network (UHN). All donors have returned to their regular lifestyle with no restrictions.

There is no monetary compensation for organ donation. There is a reimbursement program called Program for Reimbursing Expenses of Living Organ Donors (PRELOD)  funded by the Trillium Gift of Life Network. PRELOD may pay for potential expenses that happen during the evaluation process. During your preliminary appointment, a transplant assessment coordinator will talk to you about the PRELOD reimbursement program and how to apply for it.

Once a recipient is listed for transplant at UHN, the UHN living liver donor program will begin evaluating applications from donors.

If you are interested in becoming a living liver donor, please complete the Living Donor Health History Form  and attach a copy of your blood donor card, or a letter or blood test from your family doctor indicating your blood type.

Another donor may be undergoing their evaluation when you apply. The living liver donor program only evaluates one donor at a time because of the costs involved to the individual being evaluated and to the health care system. The pace of the donor evaluation is driven by donor safety and the time needed to obtain fully informed consent.

Yes, you can withdraw from the evaluation process without any explanation. Your privacy will be respected. If you decide to withdraw, please let us know as soon as possible so we can begin assessing other potential donors in a timely manner.

Donor safety is foremost concern of the live donor program. The donor evaluation is never rushed or compromised, even when the recipient is very ill.

Yes, please submit a completed Living Donor Health History Form . Our living donor coordinator will contact you to discuss our Desensitization Program for liver recipients and Paired Liver Donation or List Exchange Program for donors.

While waiting for surgery, donors must avoid all behaviours that would put them at risk for acquiring infections (HIV, HCV, syphilis, etc.) that could be transmitted to the recipient. We specifically recommend:

• Abstaining from any high risk behaviours (unprotected sex, intravenous drugs, tattoos, piercings, etc.).
• Taking steps to avoid disease transmission through sexual contact (condoms), or as a result of West Nile virus (wearing long sleeve shirts and pants and using mosquito repellant).

Smoking and the birth control pill are avoidable risk factors for blood clots after surgery, therefore, we ask donors to stop smoking prior to donation. We also ask women using any form of hormonal birth control or replacement therapy to stop this medication and use two alternative forms of contraception before donation. Alcohol and marijuana must be avoided completely for 4 weeks before surgery and for at least 8 weeks after the surgery.

There are not enough deceased donor organs to meet the needs of listed liver recipients. In Toronto, at any point in time, there are approximately 200 people waiting for liver transplantation. The waiting time for deceased donor liver transplantation ranges from days to months to years, depending on the health status of the recipient. Each year 30-60 patients referred to our program for a liver transplant die during their work-up or while waiting for a deceased donor organ.

Living donor liver transplantation reduces the risk of health deterioration and death for patients who need a liver transplant. In Toronto, survival from the time of list is much better for those who undergo living donor liver transplantation compared with those who wait for a deceased donor organ.

A living liver donor transplant can also be performed before the recipient's health severely deteriorates, and may allow for a faster recovery. It provides the recipient with a high quality organ whereas approximately 35% of deceased donor organs may be less than ideal due to advanced donor age, mild to moderate liver abnormalities, incomplete knowledge of the donor's health history and the use of extended criteria, exceptional release and donation after cardiac death. A living liver donor transplant allows recipients to bypass the risks of waiting for a deceased donor graft. After transplantation, the long-term outcomes with live donor liver grafts and deceased donor liver grafts are similar.

Donor safety is our #1 priority. Only 20 to 30% of those who indicate an interest in liver donation actually undergo this surgery. Some of the more common reasons for not proceeding to surgery include unsuitable blood vessel structure, abnormal blood tests and medical problems not previously identified or known. At any stage, the potential donor or the healthcare team may decide that it is inappropriate to proceed with liver donation. Due to patient confidentiality, the team is not able to provide recipients with information about the donor review process or the reason why a donor is unsuitable.

You will meet with members of the living donor team. We will talk to you about donation to make sure you are well informed about this option. Donor safety is our foremost concern. We also need to know that donors are choosing this freely without pressure. You or the donor team may decide that being a living donor is not in your best interest. All meetings with the donor team will be private. The person who needs the transplant will only know if the donor is suitable or unsuitable. No other information about the assessment will be shared.

If you wish to speak with someone who has undergone the living liver donor process, please let the Living Liver Donor Assessment office know and we will arrange an opportunity to speak with one of our past donors. You can also email livingorgandonation@uhn.ca.​