Understanding the Different Types of Liver Transplants

Liver transplantation is a life-saving procedure for patients with end-stage liver disease or acute liver failure. As medical science advances, multiple types of liver transplants have evolved to suit different patient needs, donor availability, and clinical conditions. Whether you're a patient, caregiver, or healthcare professional, understanding these types can help you make informed decisions during a critical time.

In this blog, we'll explore the main types of liver transplants, their differences, and when each is typically recommended.

What Is a Liver Transplant?

A liver transplant is a surgical procedure that replaces a diseased or failing liver with a healthy liver from a donor. The transplant may involve a whole liver or a portion of one, depending on the type of transplant and the donor source.

1. Deceased Donor Liver Transplant (DDLT)

What It Is:

In a DDLT, the liver is taken from a person who has been declared brain-dead but whose organs are still functioning. The entire liver is typically transplanted into the recipient.

When It's Used:

This is the most common type of liver transplant performed worldwide and is often used in patients with end-stage liver disease, cirrhosis, or liver cancer.

Benefits:

• Suitable for adult recipients

• High availability in countries with organized organ donation systems

2. Living Donor Liver Transplant (LDLT)

What It Is:

In LDLT, a portion of the liver is surgically removed from a living donor—often a close relative—and transplanted into the recipient. Both donor and recipient livers regenerate to near-normal size within weeks.

When It's Used:

• When deceased donor organs are not readily available

• In elective transplants or when time is critical

Benefits:

• Shorter waiting time

• Better pre-transplant health of recipient

• Higher long-term survival rates

3. Split Liver Transplant

What It Is:

A single liver from a deceased donor is split into two parts—usually one smaller portion for a child and a larger portion for an adult. Both parts are transplanted into two different recipients.

When It's Used:

• When both pediatric and adult recipients are on the transplant list

• In centers with advanced transplant expertise

Benefits:

• Saves two lives with one liver

• Efficient use of available organs

4. Auxiliary Liver Transplant

What It Is:

A partial liver is transplanted without removing the patient’s original liver. This is done in select cases where there is a possibility the native liver may recover, such as in acute liver failure.

When It's Used:

• Acute liver conditions (e.g., drug-induced liver injury)

• Children with metabolic liver disorders

Benefits:

• Reversible option if native liver recovers

• Reduces long-term need for immunosuppression

5. Domino Liver Transplant

What It Is:

In rare cases, a patient with a genetic liver disorder (that affects liver function in the long-term but not immediately) donates their liver to another patient. This happens when that liver is still functionally viable.

When It's Used:

• In specific metabolic conditions like familial amyloidosis

Benefits:

• Expands the donor pool

• Offers new hope to patients with rare conditions

Factors That Determine the Type of Liver Transplant

Several medical and logistical factors guide the choice of liver transplant, including:

• Severity of liver disease (MELD score)

• Patient age and body size

• Urgency of transplant

• Availability of donor (living or deceased)

• Underlying liver condition (e.g., cancer, cirrhosis, hepatitis)

Geographic and Institutional Variations

The type of liver transplant offered may also depend on the transplant center, regional policies, and organ donation practices in your country. For example:

• In India and the Middle East, living donor liver transplantation is more common due to limited deceased donors.

• In the United States and Europe, deceased donor liver transplants dominate, thanks to robust donor networks.

• Pediatric transplants often involve split livers in advanced hospitals.

  
  

Conclusion

Understanding the different types of liver transplants helps patients and families make empowered decisions. From deceased and living donors to advanced options like auxiliary and domino transplants, each method plays a vital role in saving lives. If you're considering liver transplantation, consult a qualified liver transplant physician or gastroenterologist to evaluate the most suitable option based on your health profile and available resources.

FAQ

Q1: Can a person live with a portion of their liver?Yes, both donors and recipients can live healthy lives after partial liver transplants due to the liver’s ability to regenerate.

Q2: What is the success rate of liver transplants?Success rates vary but generally range from 85–90% one-year survival rates, depending on the type and timing of the transplant.

Q3: Is liver transplant a cure for liver disease?While it replaces a failing liver, it does not cure the underlying condition. Continuous follow-up and lifestyle adjustments are essential post-transplant.