Who can Donate Liver for Transplant?

Medically Reviewed by Dr. Aman Priya Khanna
Written by Sangeeta Sharma, last updated on 9 December 2023
Who can Donate Liver for Transplant?

Liver transplantation is a medical marvel that can breathe new life into those facing critical liver conditions. However, the shortage of available donor livers is a challenge. 

The first successful deceased donor liver transplant (DDLT) and living donor liver transplant (LDLT) in India took place in 1998. India witnesses over 1800 liver transplants (LT) each year across 90-100 active LT centres. 

Read below to know more about the eligibility criteria for who can donate liver for transplant.

Understanding Liver Transplantation

Liver transplantation is a life-saving medical procedure that saves lives by replacing a damaged liver with a healthy one from a donor.

Liver regeneration enables the feasibility of living donor liver transplantation. Individuals can contribute up to 60% of their liver for transplantation. 

Within approximately six weeks, the transplanted liver segment develops into a fully functional organ in the recipient. Meanwhile, the donor's remaining liver regenerates to restore the donated portion.

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Who can Donate Liver for Transplant?

The liver donors serve a unique purpose in providing hope and a new lease on life for those in need. Two kinds of donors can be considered for liver transplant:

  1. Deceased Donor (Cadaveric): Organs are obtained from individuals who recently passed away. Deceased donor liver transplant helps save lives by utilising organs from individuals who have generously chosen to donate upon their death.
    When someone has been in an accident and is brain-dead, the liver (and other organs) may be used with due permission from the family for transplant to any patient who needs it.
  2. Living Donor: A healthy person donates roughly 2/3rd portion of their liver, which then regenerates in both the donor and recipient. Living donor liver transplant allows for timely interventions, minimising wait times and increasing the chances of successful transplantation.

Donor types for liver transplant image

Eligibility of Donors in Liver Transplantation

Specific criteria must be met to be eligible as a liver donor for transplant. The eligibility criteria of the ideal donor are:

  1. Family Relationship: The preferred liver donor is someone from the patient's family, ensuring a close biological connection.

  2. Age Range: Donors should be between 18 and 55 years old, ensuring they are in an age group conducive to successful liver donation.

  3. Weight Range: The donors are expected to weigh 50 and 90 kg, emphasising a healthy weight rather than excessive body fat.

  4. Blood Group Compatibility: Donors must share the same blood group as the patient or have blood group O for a compatible transplant.

Eligibility for liver transplant image

Ineligible Donors in Liver Transplantation

Individuals with certain health conditions may be ineligible to be liver donors. The following factors exclude individuals from being potential donors in a liver transplant:

  1. Prior Hepatitis B or C Infection: People with a history of Hepatitis B or C are not considered eligible for liver donation due to potential complications and risks associated with the transplant.

  2. HIV Infection: Those who are diagnosed with HIV are ineligible as liver donors. The virus may pose additional risks during the transplant process.

  3. Active Alcoholism or Frequent Heavy Alcohol Use: Individuals engaged in active alcoholism or who regularly consume heavy amounts of alcohol are excluded from being liver donors. It is due to the impact of alcohol on liver health.

  4. Undergoing Treatment for Psychiatric Illness: Individuals currently undergoing treatment for psychiatric illnesses are not eligible as liver donors. Their mental health conditions may affect the overall success of the transplant.

  5. Recent History of Cancer: Individuals with a recent history of cancer are not considered suitable donors. The presence of cancer may complicate the transplant procedure and pose risks to both the donor and the recipient.

  6. Significant Medical Condition: Individuals with a significant medical condition like diabetes, chronic kidney diseases, etc, are ineligible as liver donors due to the potential impact on the success and safety of the transplant.

Pre-Transplantation Workup of the Donor

Before the day of the liver transplant, thorough pre-transplant evaluations ensure a seamless process. From tumour assessments to a comprehensive array of blood investigations, each step is meticulously designed to pave the way for a successful liver transplant.

Donors undergo pre-transplant workups as outpatients (OPD basis) to assess their suitability for the procedure. It ensures they are in good health for the donation.

The pre-transplant workup generally spans 5-7 days in normal cases. However, in emergency situations, it can be expedited, taking place within 24-48 hours. 

Below is the day-wise pre-transplantation workup of a donor:


Living donors undergo a thorough evaluation on the first day. It includes health surveys, blood tests, viral serology, imaging studies, and assessments by independent healthcare professionals to ensure their suitability for surgery. 

The tests on day-1 include:

  1. Tumor Evaluation (for cancer cases): Assessing the presence and extent of tumours is crucial for determining the overall health and suitability for transplant.

  2. Blood Investigations: Identifies compatible donors and recipients. It evaluates overall blood health.

  3. Viral Markers:  Screening for hepatitis, HIV, and syphilis infections.

  4. Viral Infections and Immunity: Assessing immunity and detecting active viral infections.

  5. Tumour Markers and Immunoglobulins: Overall immune system health is monitored.

  6. Autoimmune Markers: Evaluating autoimmune factors that may impact transplantation. It examines the presence of autoimmune liver disease.

  7. Viral Load Testing: Measuring the amount of hepatitis C and B viruses in the blood. 

  8. Urine Tests: Assessing kidney function and protein levels in urine.

  9. Thyroid Function and Lipid Profile: Evaluating thyroid function and lipid levels for overall health.

  10. Arterial Blood Gas: Measuring oxygen and carbon dioxide levels in the blood to assess respiratory function.

  11. Chest X-ray (PA): Obtaining a comprehensive view of the chest to evaluate lung and heart health before surgery.

Screening Parameter
Blood Investigations
  1. Blood Groups

  2. Complete Blood Count (CBC)

  3. Prothrombin Time (PT)

  4. Partial Thromboplastin Time (PTT)

  5. International Normalized Ratio (INR)

Thyroid Function and Lipid Profile
  1. Free Triiodothyronine (Free T3)

  2. Free Thyroxine (Free T4)

  3. Thyroid-Stimulating Hormone (TSH)

  4. Lipid Profile (Fasting)

Viral Markers
  1. Hepatitis B Surface Antigen (HBsAg)

  2. Hepatitis C Virus Antibody (HCV Ab)

  3. Human Immunodeficiency Virus (HIV)

  4. Anti-Hepatitis B Surface (Anti HBs) Titers

  5. Hepatitis B Core Antibody (HBc Ab)-Total 

  6. Venereal Disease Research Laboratory (VDRL)

Viral Infections and Immunity
  1. IgG 

  2. CMV – IgM

  3. Varicella Zoster Virus IgG

  4. Hepatitis A Virus (HAV) IgG

  5. HAV IgM

  6. Hepatitis E Virus (HEV) IgG

  7. HEV IgM

  8. Dengue IgM

Tumour Markers and Immunoglobulins
  1. Alpha-Fetoprotein (AFP)

  2. Carcinoembryonic Antigen (CEA)

  3. Cancer Antigen 19-9 (CA 19-9)

  4. Prostate-Specific Antigen (PSA) for males

  5. Total Immunoglobulin G (Total IgG)

Autoimmune Markers
  1. Smooth Muscle Antibody (SMA)

  2. Antimitochondrial Antibody (AMA)

  3. Antinuclear Antibody (ANA)

  4. Perinuclear Antineutrophil Cytoplasmic Antibody (P-ANCA)

  5. Liver Kidney Microsomal Antibody (LKMA) using the Indirect Immunofluorescence Assay (IFA Method)

Urine Test
  1. Urine Routine/Microscopic

  2. 24-Hour Urine for Creatinine Clearance

  3. 24-Hour Urine for Protein Creatinine Ratio

  4. Urine Culture/Sensitivity

Arterial Blood Gas
Measuring oxygen and carbon dioxide levels in blood
Chest X-ray
Evaluating lung and heart health
Viral Load Testing
  1. Hepatitis C Virus RNA Quantitative (HCV-RNA Quantitative) 

  2. Hepatitis B Virus DNA Quantitative (HBV-DNA Quantitative)


On the second day of the pre-transplantation workup, various diagnostic tests are performed to ensure the donor's suitability for the procedure. The tests are:

  1. Ultrasound (Whole Abdomen): A thorough abdominal ultrasound is conducted to assess the condition of the liver and surrounding organs.

  2. Hepatic Doppler:  Imaging by Doppler focuses on the blood vessels in the liver, providing insights into the blood flow in this organ.

  3. Pulmonary Function Tests (PFT): Tests are conducted to evaluate the donor's lung function, ensuring their respiratory health is suitable for the transplantation process.

  4. ECG (Electrocardiogram): An ECG is performed to assess the rhythm of the heart and detect any abnormalities.

  5. ECHO (Echocardiogram): This test provides a detailed view of the heart's structure and function, ensuring the donor's cardiac health is optimal.

  6. Dobutamine Stress ECHO (including Bubble ECHO): Stress testing of the heart, including dobutamine, helps evaluate cardiac function under exertion. Bubble echo detects potential heart defects.

  7. CT Calcium Scoring: A computed tomography scan is employed to assess calcium deposits in the coronary arteries, aiding in the evaluation of heart health.

  8. CECT (Triphasic) Abdomen: Contrast-enhanced computed tomography offers a detailed view of the blood vessels and structures in the abdomen, providing crucial information for the transplant assessment.

  9. Hepatology Review and Endoscopy: A comprehensive review by hepatologists and endoscopy helps evaluate the overall liver health and identify potential issues that may impact the transplant process.

Day 2 Donor workup image


As the evaluation process for potential liver donors continues, the third day of pre-transplantation workup focuses on ensuring the donor's overall well-being. This involves assessments from various medical specialists to guarantee suitability for the transplantation process.

  1. Cardiac, Pulmonary, and Neurological Clearance: Rigorous assessments by specialists ensure the donor's heart, lungs, and neurological functions are in optimal condition, minimizing risks during the liver transplant.

  1. Psychiatry, Dietician, Physiotherapy Assessment: Evaluations by psychiatrists, dieticians, and physiotherapists aim to assess the donor's mental health, dietary habits, and physical well-being, contributing to an overall understanding of their fitness for the transplantation procedure.

  2. Anaesthesia Check-up: Anaesthesia specialists conduct a thorough examination to ensure the donor can safely undergo the anaesthesia required for the liver transplant, addressing potential complications.

Day 3 donor workup image

On the Day of the Liver Transplant

Once the legal authorisation process is completed, the donor is considered suitable for transplant surgery.

Donor surgery begins first and lasts around 10-12 hours. It involves removing 50-60% of the donor's liver. The timing of the recipient surgery, lasting approximately 6-8 hours, is coordinated with the progress of the donor's liver. 

Below is the description of the whole process:

  1. General anasesthesia is given to the patient after positioning them in supine position.

  2. Surgeons start by taking a section of the donor's liver for transplant, typically through a stomach incision.

  3. The specific part of the donor's liver chosen depends on both its size and the requirements of the recipient.

  4. Following this, the surgeons remove the damaged liver from the recipient and insert the donated liver section into the body.

  5. The blood vessels and bile ducts are meticulously connected to the new liver during the surgery.

  6. Post-transplant, both the transplanted liver in the recipient and the remaining portion in the donor regenerate rapidly, restoring to normal volume and function within a few months.

Liver Transplant procedure image

Hospital Stay and Recovery after Liver Transplant

Following the transplant, patients typically remain in the hospital for approximately 2-4 weeks, depending on the individual's recovery progress.

After leaving the hospital, patients are advised to stay in proximity for 2-4 weeks to facilitate close monitoring and prompt medical attention if needed.

Liver regeneration starts immediately after the surgery, reaching normal size within six to eight weeks. Close monitoring for signs of recovery and liver regeneration occurs during the early post-surgery period.

The recovery phase for the donor is explained below:

  • In the initial recovery phase, you might experience some discomfort at the incision site, but it's usually well managed with pain medications.

  • Post-discharge guidelines include refraining from lifting anything over 20 pounds for at least six weeks and avoiding driving while on sedating medications for two to three weeks.

  • Regular walks are encouraged, and you may need assistance initially.

  • Depending on your job, a return to work might be possible six to eight weeks after surgery.

  • Ongoing recovery is closely monitored through routine clinic visits and laboratory tests.

Choose HexaHealth for Liver Transplant

HexaHealth stands by your side throughout your treatment journey. We've got you covered. You can be assured that you get comprehensive support without any limitation from:

  1. Partnering with you at every step, from doctor appointments to diagnostic tests and admission planning.

  2. Offering support beyond hospital visits, including out-of-hospital assistance, psycho-social counselling, and disease education.

  3. Collaboration with leading hospitals in India equipped with specialized liver transplant departments.

  4. Providing financial aid by facilitating zero-cost EMI options for treatment costs, with a limit of up to ₹ 4,00,000 for a duration of 12 months.

  5. Tailoring funding solutions to meet your specific needs, offering lower-than-market interest rates for higher tenures and amounts.

Why Hexahealth image

Dedicated to your well-being, HexaHealth recognized the need for a holistic approach to address this challenge. Introducing the National Liver Board, a team of leading experts in liver health committed to guiding every patient with liver disease towards a speedy recovery.


Liver transplantation (LT) stands out as an exceptionally effective treatment for individuals with advanced stages of liver failure. With a success rate of around 90%, living donor liver transplants pave the way for patients to enjoy healthy lives. 

HexaHealth is dedicated to providing affordable, top-notch liver transplant surgeries in India. Feel free to reach out for information on the procedure, costs, potential side effects, hospital stay, financing options, and recovery after surgery.

To read more about liver transplant, click on the links below:

Types of Liver Transplant
Liver Transplant Criteria
Paediatric Liver TransplantOrthotopic Liver Transplant
Robotic Liver Transplant
Laparoscopic Liver Transplant
Indications For Liver Transplant
Paediatric Liver Transplant Waiting List
Liver Transplant Success Rate
Top 10 Paediatric Liver Transplant Hospitals
Paediatric Liver Transplant Complications
Financing Options for Liver Transplant in India
Risks and Complications After a Liver Transplant
Liver Transplant Rejection
Health Insurance for Liver Transplant in India
Unknown Facts about Liver Transplant Surgery
Best Liver Transplant Surgeon in India
Best Liver Transplant Hospital in India

Frequently Asked Questions

Who can donate liver to whom?

The liver can be donated either by a living donor or a recently deceased person. The donor who is eligible for a liver transplant includes:

  1. The liver donor must be a family member of the patient.

  2. Donors should be between 18-55 years old.

  3. The weight of the donor must be between 50-90 kg, excluding excessive fat.

  4. The blood group should be the same as the patient or O group.

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Who cannot donate liver for transplant in India?

Ineligible donors include those with:

  1. History of Hepatitis B or C, HIV infection

  2. Ongoing alcoholism or regular heavy alcohol use 

  3. Current treatment for psychiatric illness 

  4. Recent cancer history

  5. Medical conditions like autoimmune disorders

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Do liver donors have to be family?

Typically, living liver donors are close relatives like family members, partners, or close friends of the recipient. However, individuals without a personal connection to someone with liver disease can also donate a portion of their liver to someone in need on the transplant list.

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Is liver donation safe?

Donating a liver is safe because the organ regenerates, returning to its original size within six weeks after removing a portion.

The donors experience no long-term effects. They need minimal medication for 2-3 weeks and can resume normal activities within a month, including strenuous exercises like weight lifting, after three months.

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Who can donate liver to B+?

Type B blood individuals can donate to recipients of B or AB groups. People with B+ blood can receive a liver transplant from donors with B+ or O+ blood. Other blood types are not compatible with liver donation to B+ individuals.

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What precautions should be taken after a liver transplant for the donor?

After a liver transplant, one must adhere to the doctor's advice for a smooth recovery. Some precautions after the surgery includes:

  1. Avoid lifting anything over 20 pounds for at least six weeks after leaving the hospital.

  2. Refrain from driving when using sedating medications, typically prescribed for two to three weeks post-discharge.

  3. Embrace multiple short walks daily to support your recovery and well-being.

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How long does it take for donor evaluation in a liver transplant?

Donor evaluation involves a series of tests conducted in different phases. The pre-transplant evaluation typically spans 5-7 days under normal circumstances. It is expedited and completed within 24-48 hours in an emergency.

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What is authorization committee clearance?

Authorisation clearance is consent essential for a living donor transplant and is obtained from a government-appointed committee. Scheduling a transplant is only possible after getting this clearance. Donors and recipients must submit proof of identity, residence, and relationship.

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What happens to a donor after a liver transplant?

A living donor liver transplant involves taking a part of a healthy person's liver and placing it into someone with a malfunctioning organ. The donor's remaining liver regenerates and returns to its usual size, volume, and function within a few months after the surgery.

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How long can a donor's liver be kept?

In case of deceased donor liver transplant, the organ can be preserved for a limited time, usually around 12 hours, before transplantation. This timeframe allows for careful matching and logistics to ensure successful transplantation for the recipient.

The living donor transplantation is simultaneously done.

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Can a liver donor live a normal life?

Yes, liver donor can live a normal life after donating their part of the liver. Most liver donors can resume daily activities, such as showering about a week after returning home following discharge from the hospital.

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What can you eat after donating your liver?

Include the following in your diet after donating your liver for a smooth recovery:

  1. Fruits and Veggies: Consume at least five servings of fruits and vegetables daily.

  2. Whole Grains: Opt for fibre-rich wholegrain foods for a healthy diet.

  3. Avoid Sugar Intake: Manage diabetes by avoiding excessive sugar in your diet.

  4. Limit Saturated Fats: Control cholesterol levels with a diet low in saturated fats.

  5. Moderate Salt Intake: Keep salt consumption in check for overall health.

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How many times can you donate a liver?

Once you've donated a part of your liver, you cannot repeat the donation. In about eight weeks, your donor's liver is expected to fully or nearly fully recover to its normal size.

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How long does a liver take to regenerate after donation?

Following donation, the liver function normalizes within two to four weeks. It gradually regrows to nearly its full original size within a year.

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Can a liver donor live without a liver?

No, a person cannot live without a liver. It is an important organ for survival. It plays a crucial role in managing blood waste, purging toxins, and storing surplus energy as glycogen.

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How many hours is liver donor surgery?

The donor surgery lasts six to eight hours, with separate operating rooms for the recipient and donor. A team of surgeons conducts both surgeries simultaneously. A hockey stick-shaped incision is created in the donor's upper right abdomen.

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What are the risks for the liver donor after the surgery?

The risks of the donor include:

  1. Infection Risk: There is a chance of infection at the surgery site for some living-liver donors. The transplant team will closely monitor and manage the health to minimise potential complications.
  2. Bleeding: There is a potential for bleeding during and after the surgery.
  3. Painful Incision: The incision may cause discomfort and pain, which can be managed with appropriate care and pain relief measures.
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How painful is liver donation?

You can expect considerable pain following the surgery. Pain relief medications are provided to minimise the discomfort. It lessens each day. Many donors experience notable discomfort for two to four weeks post-surgery.

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Can a liver donor get pregnant?

Yes, you can conceive and have a baby even if you donate a portion of your liver. It does not affect your ability to become pregnant or give birth.

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All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.

  1. Shroff S. Legal and ethical aspects of organ donation and transplantation. Indian J Urol. 2009 Jul;25(3):348-55. doi: 10.4103/0970-1591.56203. PMID: 19881131; PMCID: PMC2779960.link
  2. FAQ: Living liver donor. ucsfhealth.org. UCSF Health; 2021 [cited 2023 Dec 5].link
  3. Choudhary NS, Bhangui P, Soin AS. Liver Transplant Outcomes in India. Clin Liver Dis (Hoboken). 2022 Jan 24;19(1):32-35. doi: 10.1002/cld.1166. PMID: 35106148; PMCID: PMC8785916.link
  4. Humar A. Adult living donor transplants-which portion of the liver to use? Liver Transpl. 2003;9(6):634–6link
  5. Rivera W. An introduction for donors and recipients. American Liver Foundation. 2022 [cited 2023 Dec 5].link
  6. Becoming a living liver donor. ucsfhealth.org. UCSF Health; 2023 [cited 2023 Dec 5].link
  7. Living donor liver transplant. Uofmhealth.org. [cited 2023 Dec 5].link
  8. Nadalin S, Bockhorn M, Malagó M, Valentin-Gamazo C, Frilling A, Broelsch CE. Living donor liver transplantation. HPB (Oxford). 2006;8(1):10-21. doi: 10.1080/13651820500465626. PMID: 18333233; PMCID: PMC2131378.link
  9. Shah SA, Levy GA, Adcock LD, Gallagher G, Grant DR. Adult-to-adult living donor liver transplantation. Can J Gastroenterol. 2006 May;20(5):339-43. doi: 10.1155/2006/320530. PMID: 16691300; PMCID: PMC2659892.link
  10. Living donor liver transplant. Organ transplantation - NHS Blood and Transplant. [cited 2023 Dec 5].link
  11. Organ transplantation in India. Organindia.org. 2014 [cited 2023 Dec 5]link

Updated on : 9 December 2023


Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More


Sangeeta Sharma

Sangeeta Sharma

BSc. Biochemistry I MSc. Biochemistry (Oxford College Bangalore)

6 Years Experience

She has extensive experience in content and regulatory writing with reputed organisations like Sun Pharmaceuticals and Innodata. Skilled in SEO and passionate about creating informative and engaging medical conten...View More

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