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What Are The Advantages Of Having Living Related Donor For Liver Transplant?
Question: Mother - 58y, Cirrhosis, Advised Liver Transplant. Brother - 33y, otherwise healthy, planned donor.
Is there an advantage in having a blood related donor e.g. my brother, vs. someone who is unrelated? If yes, how much is the advantage?
To be precise, what I want to know is this:
Is it a significant advantage to let my brother be the donor for the benefit that he is blood-related to my other. If it does not matter that much, then I will rather find another donor - assuming we can find a matching donor.
I understand if you may not want to take a position, but I need all the information you can provide me, and then also what you would have done had it been your family.
Is there an advantage in having a blood related donor e.g. my brother, vs. someone who is unrelated? If yes, how much is the advantage?
To be precise, what I want to know is this:
Is it a significant advantage to let my brother be the donor for the benefit that he is blood-related to my other. If it does not matter that much, then I will rather find another donor - assuming we can find a matching donor.
I understand if you may not want to take a position, but I need all the information you can provide me, and then also what you would have done had it been your family.
Brief Answer:
Blood relatedness has no importance in liver transplantation.
Detailed Answer:
Hello, Sir.
I undertsand your concern.
I have gone through your query in detail.
Well, the role of HLA in liver transplant is uncertain since there are no studies which show its beneficial effect on liver transplant survival.Hence it does not depend on blood relatedness(HLA matching).
Matching depends mainly of blood group compatibility and other parameters like MELD scores.
Living donor liver transplantation is often beneficail for the following reasons.
Most donated livers come from deceased donors—donors who have recently died. Adults usually receive the entire liver from a deceased donor, although a segment of the liver can be transplanted when the donor liver is too large.
A small number of liver transplants are performed using living donors. Most living donors are relatives of the recipient.
In living donor transplantation, a segment of the donor’s healthy liver is surgically removed and transplanted into the recipient. Because a healthy liver can regenerate, the donor’s liver soon grows back to normal size after the surgery, while the segment of the liver that was transplanted into the recipient also grows to normal size.
Hence to conclude, I would suggest the option f your brother donating the liver to your mother.
Post your further queries if any.
Thank you.
Blood relatedness has no importance in liver transplantation.
Detailed Answer:
Hello, Sir.
I undertsand your concern.
I have gone through your query in detail.
Well, the role of HLA in liver transplant is uncertain since there are no studies which show its beneficial effect on liver transplant survival.Hence it does not depend on blood relatedness(HLA matching).
Matching depends mainly of blood group compatibility and other parameters like MELD scores.
Living donor liver transplantation is often beneficail for the following reasons.
Most donated livers come from deceased donors—donors who have recently died. Adults usually receive the entire liver from a deceased donor, although a segment of the liver can be transplanted when the donor liver is too large.
A small number of liver transplants are performed using living donors. Most living donors are relatives of the recipient.
In living donor transplantation, a segment of the donor’s healthy liver is surgically removed and transplanted into the recipient. Because a healthy liver can regenerate, the donor’s liver soon grows back to normal size after the surgery, while the segment of the liver that was transplanted into the recipient also grows to normal size.
Hence to conclude, I would suggest the option f your brother donating the liver to your mother.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dear Dr. Heijebu,
Thank you for your answer. However, I didn't quite follow one thing.
My question was that I have the option of my brother being the donor, and I can explore the option of another person, with a matching blood group, being the donor. Let us assume that I can find a willing donor who is not a blood relative.
Now, given that I have both options, i.e. my brother (blood relative) or someone else who is not a blood relative, what should I choose?
If my mother have a better chance with my brother, I will choose that.
If it does not matter whether its my brother or someone who is not blood related, then I will want to avoid putting my brother through the trauma and risk of surgery.
As to your response, on one hand you said that "Blood relatedness has no importance in liver transplantation."
But then you conclude that you would suggest the option of your brother donating the liver to your mother. As I clarified above, I would want my brother to take the risk only if it gives my mother some advantage. Will appreciate a quick reply - as I need to make some decisions.
Also, in addition, would you recommend that we ask a liver specialist too? If so, can you additionally refer this question to such a specialist within HCM?
Thank you for your answer. However, I didn't quite follow one thing.
My question was that I have the option of my brother being the donor, and I can explore the option of another person, with a matching blood group, being the donor. Let us assume that I can find a willing donor who is not a blood relative.
Now, given that I have both options, i.e. my brother (blood relative) or someone else who is not a blood relative, what should I choose?
If my mother have a better chance with my brother, I will choose that.
If it does not matter whether its my brother or someone who is not blood related, then I will want to avoid putting my brother through the trauma and risk of surgery.
As to your response, on one hand you said that "Blood relatedness has no importance in liver transplantation."
But then you conclude that you would suggest the option of your brother donating the liver to your mother. As I clarified above, I would want my brother to take the risk only if it gives my mother some advantage. Will appreciate a quick reply - as I need to make some decisions.
Also, in addition, would you recommend that we ask a liver specialist too? If so, can you additionally refer this question to such a specialist within HCM?
Brief Answer:
Your brother as liver donor is the safe and the best option.
Detailed Answer:
Hello, Sir.
I understand your concern.
I apologise for the delayed response.
I refer blood relatedness to HLA matching-This has no significance in liver transplant outcome -which means both your brother as well any other outside person can donate their liver to your mother.Okay.This is based on recent study report.
Despite this fact, the risk of transplant rejection in the recipient(your mother)will always be less if the donor is HLA (tissue type compatible) compatible with the recipient.This compatibility is possible with your brother.
Secondly, the liver transplant from your brother has an additional advantage as follows.
Because a healthy liver (of your brother )can regenerate, the donor’s liver soon grows back to normal size after the surgery, while the segment of the liver that was transplanted into the recipient also grows to normal size.Size and blood group incompatibility can be a problem with outside donors.Hence, it is better to go with your brother as the risk of transplant rejection owing to blood group incompatibility, is very less.
Therefore even though blood group of the outside person matches with your mother, there can still be undetermined variations in blood group and tissue antigens with those of your mother.These undetected minor antigenic variations can contribute to graft rejection problems later on.
To express in numerical terms- The success with outside donor is 90 % and with your brother can be 95-99%.
A good donor should also:
1.be willing to donate: No one should feel that they MUST donate.Donors should 2.be free from any pressure or guilt associated with the donation and cannot be paid for their donation.
3.be well informed: A good donor candidate has a solid grasp of the risks, benefits, and potential outcomes, both good and bad, for both the donor and recipient.
4.have good support: Significantly should support your decision.
The above advantages can always be in your favour if the donor is your own brother.
I do not have the option of directly referring this query of yours to a Liver transplant surgeon on HCM.You need to contact HCM directly for your requirements.
Post your further queries if any.
Thank you.
Your brother as liver donor is the safe and the best option.
Detailed Answer:
Hello, Sir.
I understand your concern.
I apologise for the delayed response.
I refer blood relatedness to HLA matching-This has no significance in liver transplant outcome -which means both your brother as well any other outside person can donate their liver to your mother.Okay.This is based on recent study report.
Despite this fact, the risk of transplant rejection in the recipient(your mother)will always be less if the donor is HLA (tissue type compatible) compatible with the recipient.This compatibility is possible with your brother.
Secondly, the liver transplant from your brother has an additional advantage as follows.
Because a healthy liver (of your brother )can regenerate, the donor’s liver soon grows back to normal size after the surgery, while the segment of the liver that was transplanted into the recipient also grows to normal size.Size and blood group incompatibility can be a problem with outside donors.Hence, it is better to go with your brother as the risk of transplant rejection owing to blood group incompatibility, is very less.
Therefore even though blood group of the outside person matches with your mother, there can still be undetermined variations in blood group and tissue antigens with those of your mother.These undetected minor antigenic variations can contribute to graft rejection problems later on.
To express in numerical terms- The success with outside donor is 90 % and with your brother can be 95-99%.
A good donor should also:
1.be willing to donate: No one should feel that they MUST donate.Donors should 2.be free from any pressure or guilt associated with the donation and cannot be paid for their donation.
3.be well informed: A good donor candidate has a solid grasp of the risks, benefits, and potential outcomes, both good and bad, for both the donor and recipient.
4.have good support: Significantly should support your decision.
The above advantages can always be in your favour if the donor is your own brother.
I do not have the option of directly referring this query of yours to a Liver transplant surgeon on HCM.You need to contact HCM directly for your requirements.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dear Dr. Heijebu,
Your answer is much appreciated. It is exactly the information what I was looking for. If you have the web link (URL) for such research or numerical terms/stats, please do share it. Not critical for me though.
Further, in this context, I am trying to decide between ILBS (Delhi), a govt. institute, close to our home, and where we have been consulting since the past year; and Apollo XXXXXXX which is apparently the best in XXXXXXX and I know a lot of people who have gotten their transplants done at Apollo XXXXXXX Money is not a concern.
Does it materially matter, for either of the donor or the recipient, to be in Apollo XXXXXXX or continue with ILBS. I don't know how to even think about this. We are with Apollo because it is next door, but if it matters even a little, we are prepared to go to XXXXXXX
Best regards,
Praveer
Also, this question may be beyond the scope of my original question, and if so, please let me know.
Your answer is much appreciated. It is exactly the information what I was looking for. If you have the web link (URL) for such research or numerical terms/stats, please do share it. Not critical for me though.
Further, in this context, I am trying to decide between ILBS (Delhi), a govt. institute, close to our home, and where we have been consulting since the past year; and Apollo XXXXXXX which is apparently the best in XXXXXXX and I know a lot of people who have gotten their transplants done at Apollo XXXXXXX Money is not a concern.
Does it materially matter, for either of the donor or the recipient, to be in Apollo XXXXXXX or continue with ILBS. I don't know how to even think about this. We are with Apollo because it is next door, but if it matters even a little, we are prepared to go to XXXXXXX
Best regards,
Praveer
Also, this question may be beyond the scope of my original question, and if so, please let me know.
Brief Answer:
ILBS is absolutely preferable.
Detailed Answer:
Hello, Sir.
I understand your concern.
ILBS, New XXXXXXX is the better option in my view.Although Apollo XXXXXXX is equally superior on its own terms.
The resources and expert manpower in ILBS is unmatchable.So I advise you to prefer ILBS over Apollo XXXXXXX This also serves you the purpose of home advantage.
ILBS is exclusively designed to cater your needs on Liver transplantation.
Following 2 links can be helpful(to some extent) though exhaustive and sometimes beyond the scope of our understanding.
1.http://www.thehealthsite.com/diseases-conditions/liver-transplants-frequently-asked-questions-answered-by-a-renowned-liver-transplant-surgeon/
2.http://zeenews XXXXXXX com/exclusive/liver-transplant-overall-success-rate-is-more-than-94-says-expert_0000.html
The following website can take to directly contact Dr. XXXXXXX XXXXXXX leading transplant surgeon who is available to answer all your queries and statistic details.This is the best website link I can give you-
http://www.liverhelpline.com/
Hope I have answered all your queries.
Post your further queries if any.
Thank you.
ILBS is absolutely preferable.
Detailed Answer:
Hello, Sir.
I understand your concern.
ILBS, New XXXXXXX is the better option in my view.Although Apollo XXXXXXX is equally superior on its own terms.
The resources and expert manpower in ILBS is unmatchable.So I advise you to prefer ILBS over Apollo XXXXXXX This also serves you the purpose of home advantage.
ILBS is exclusively designed to cater your needs on Liver transplantation.
Following 2 links can be helpful(to some extent) though exhaustive and sometimes beyond the scope of our understanding.
1.http://www.thehealthsite.com/diseases-conditions/liver-transplants-frequently-asked-questions-answered-by-a-renowned-liver-transplant-surgeon/
2.http://zeenews XXXXXXX com/exclusive/liver-transplant-overall-success-rate-is-more-than-94-says-expert_0000.html
The following website can take to directly contact Dr. XXXXXXX XXXXXXX leading transplant surgeon who is available to answer all your queries and statistic details.This is the best website link I can give you-
http://www.liverhelpline.com/
Hope I have answered all your queries.
Post your further queries if any.
Thank you.
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Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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