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Transplant Q&AQuestion: Can doctors be certain that a donor liver is "good" and how can they be sure?Answer: It is not possible to be certain that a liver will be a good
one. However, it is possible in many cases to tell when a liver will be
a bad one. By a bad liver, I mean that it will not function immediately
in the recipient. If the liver donor has a high serum sodium level, or
if the liver has fatty infiltration, it is known that the likelihood
that the liver will work well following transplantation is much lower.
For this reason if the sodium is high enough or if there is too much fat
in the donor liver, it is often not transplanted. The other factor that
is known to be associated with poor liver function is the appearance of
the donor liver. In other words, the subjective impression of the donor
liver by an experienced transplant surgeon is also important. Livers
that "don't look good" have rounded edges instead of sharp,
distinct ones. They also may have a swollen appearance and/or an
abnormal color. Even when none of these factors are present there is a
chance that the liver will not work in the recipient. This is called
primary non-function. It occurs after about 5% of liver transplants
overall. In these cases, an immediate and emergent re-transplant will be
required.
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Children’s Liver Association
for Support Services
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