Living Liver Donation for People with Obesity

What is obesity?

Obesity is a condition where a person is overweight or very overweight. To figure out if you have obesity, doctors will measure your height and weight to calculate your Body Mass Index (BMI). People with a high BMI may not be able to be liver donors.

Obesity can give you a higher chance of problems during a major surgery, such as liver donation.

How can obesity affect a liver donor during surgery?

Obesity could lead to problems with surgery, such as:

  • Longer surgery time
  • Losing a lot of blood
  • Issues with breathing after surgery

Obesity can also lead to problems after surgery, such as:

  • Hernia (bulging of a tissue into the belly area)
  • Poor wound healing (trouble with the incision and the tissue below)
  • Liver not working well because of fat or inflammation (swelling) in the liver

Can I be a liver donor if I am overweight or obese?

Maybe, it depends on the center. Centers will have different rules about who can safely donate. The transplant team considers factors, such as your:

  • BMI
  • Body shape
  • Blood pressure
  • Levels of fat in your blood, such as cholesterol and triglycerides
  • Chance of developing diabetes, such as family history

Your transplant team will do tests to decide if your liver is healthy enough to donate, such as:

  • Imaging test of your liver to see if there is any fat present
  • Blood test
  • Liver biopsy (taking a small piece of your liver to check it under a microscope)

What can I do if I am too overweight to donate?

Work with your main doctor (primary care physician, or PCP) or the dietitian at the transplant center to create a plan for losing weight and improving your health. Some people can lose enough weight and be healthy enough to consider living liver donation. Your plan may include:

  • A healthy eating plan
  • Being active every day for at least 30 minutes, such as to walk, garden, or bike
  • Checking your blood pressure, blood sugar (glucose), and cholesterol
  • Stopping smoking if you are a current smoker 

How can I learn more?

To learn more, see Chapter 5 on Living liver donation and biopsy

 

REFERENCES

  1. Ri M, Aikou S, Set U. Obesity as a surgical risk factor.  Annals of Gastronterological Surgery.  2018; 2:13-21. 13-21.
  2. Sugerman HJ, Kellum JM Jr, Reines HD, et al. Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg 1996;171:80-4.
  3. Wick EC, Hirose K, Shore AD, et al. Surgical site infections and cost in obese patients undergoing colorectal surgery. Arch Surg 2011;146:1068-72.
  4. Marsman WA, Wiesner RH, Rodriguez L, Batts KP, Porayko MK, Hay JE, Gores GJ, Krom RA. Use of fatty donor liver is associated with diminished early patient and graft survival. Transplantation. 1996; 62:1246–1251.
PDF icon Living-Donor-Liver-Medical-Toolkit-Ch3.pdf
PDF icon Living-Donor-Liver-Medical-Toolkit-Ch3.pdf

Note: This information is the opinion of the Living Donor Community of Practice (LDCOP) of the American Society of Transplantation. The LDCOP is a group of health care professionals and researchers who specialize in living donation. The LDCOP’s recommendations are meant to offer you helpful information, but you may find opinions from other groups or organizations that are helpful to you, too.

Last Updated: 
June 03, 2022

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