I am here to support my family member. Does anyone know if I could donate part of my liver to her? I don't know any thing about ducts but if I could donate that too I would.
Hey Dog Mom,
The good news is that the body is less picky when it comes to accepting a donated liver as opposed to a kidney. That said, there are still many factors when determining whether someone can be a living donor, the biggest being compatible blood type and liver size. A living donor donation includes a portion of the liver with the internal bile ducts and one of your two main bile ducts extending outside of the liver.
In the US, the patient usually needs to be listed for transplant in order for insurance and the doctors to get on board for initiating the living donor transplant process. Once the patient is listed, an interested party can get in contact with the patient's transplant coordinator and arrange testing to determine compatibility.
Assuming there is a compatible donor, the big question is to determine when is the right time to perform the procedure. Transplant is a compromise, not a cure. Once transplanted, the patient will be immunosuppressed for the rest of his/her life. Among other increased risks, this doubles the odds of getting all cancers. This compromise needs to be balanced against the present impact PSC has on the patient's life and the ever-present risk of cholangiocarcinoma.
One important note: it is not uncommon for PSC to return after a transplant. The odds of it recurring are higher if the patient receives a living donor transplant from a biological relative (parent, child, brothers/sisters).
-JTB
Dennis,
There are many studies with wildly different data for rates of overall recurrence. Some say 10%, others say closer to 50%, so I wouldn't say there is a consensus. What is constant between the studies is that the rate of recurrence rises over time (higher rate in a population 10 years out from transplant compared to 5 years). The studies that include living donor liver transplants also tend to suggest that the rate of recurrence for the LDLT group is higher compared to the cadaver group within the same time period out from transplant. Here are some results reported in 2013:
http://www.firstwordpharma.com/node/1153853#axzz3ToP4fKaq