Risks from the donated liver

Livers from donation after circulatory death (DCD) donors carry a greater risk of complications. These problems may result in the need for further procedures and, if unsuccessfully treated, may require re-transplantation (a second transplant). You can express your wish not to be considered for a liver from a DCD donor when entering the waiting list. Your transplant team will discuss this with you.

In general, livers from younger donors work better than livers from older donors. This is because they are less likely to have chronic health conditions.

However, deceased donors in the UK are becoming older. Approximately 25 in 100 donors are more than 65 years old.

Although donor age is important, other donor factors are also important. Focusing on donor age alone can be misleading. Given that most liver transplants from older donors do well, it is still better in most cases to have a transplant from an older donor than to stay on the transplant waiting list.

Being overweight can increase the risk of excess fat deposited in the liver. Excess fat can also accumulate if the donor has a long history of diabetes or excessive alcohol intake.

This excess fat (known as steatosis) can have a negative impact on the quality of the liver and may increase the risk of poor liver function and other complications once transplanted. 

However, 20 in 100 liver donors are obese and most livers transplanted from these donors have good function.

It is possible for donated livers to pass on diseases such as infections or cancers. It is very rare that serious diseases are passed on (less than a 1 in 1,000 chance). Unfortunately, no test can completely remove the risk of passing on a disease with a transplanted organ.

All donors are carefully assessed and screened for the presence of serious infections such as HIV and viral hepatitis. 

Livers from some donors with a history of hepatitis infection (B or C) can be suitable for transplantation. You will be informed if the donor has a history of hepatitis B or hepatitis C infection. If you accept a donated liver with hepatitis C infection, you will be given tablets to clear the infection with a 98 in 100 chance of cure. If you accept a liver with hepatitis B you will need to take a tablet on a daily basis for life. This will prevent the virus from causing damage to the transplanted liver.

Some viral infections are very common in otherwise healthy people, including organ donors, and are unlikely to cause problems in the recipient. An example of this common type of viral infection is CMV (cytomegalovirus). You will be given tablets that can successfully treat CMV infection if it is passed on from the donor to the recipient.

Learn more about the risk of infections

A liver from a donor with a past history of cancer can be associated with an increased risk of transmitting the cancer to you. This depends on the tumour type and the time interval after treatment of the tumour. There are nationally agreed guidelines, which outline when an organ should absolutely not be used. In some cases, the risk of tumour transmission from a donor may not be straightforward and may need to be considered individually. This means weighing up the risks versus benefits for you specifically.