Liver Transplant Surgery

No two liver transplants are the same. Our liver disease and transplant experts focus entirely on you and offer support before, during and after surgery.

Meet our team

Our team approach helps you recover and thrive — physically and emotionally. We work together to design a personalized treatment plan based on your unique needs, overall health and long-term goals. Your liver transplant team includes:

• Liver transplant surgeons.
• Nurses specially trained in transplant surgery.
• Hepatologists (liver specialists).
• Pharmacists.
• Dietitians.
• Social workers.

There are three different types of liver transplant surgery options we can choose from:

Living donor liver transplant

In a living donor liver transplant, we give you part of a healthy living person’s organ. Your liver has two lobes, right and left, and each has its own blood flow. Because healthy liver tissue quickly regrows, we can take one of the lobes from your living donor and give it to you, leaving the other lobe in the donor.

Our surgical team pioneered and perfected this technique, which lets you avoid waiting for (maybe) years for a donor liver from someone who’s died. This means you can have surgery in the earlier stages of your disease and get better outcomes. Because the liver you receive is taken from a healthy living donor instead of a deceased donor, the quality of the liver is better.

Your donor could be a relative, friend or even a person you don’t know. Your living donor must be healthy and have a blood type that matches yours. If your blood type doesn’t match with your recipient, you can participate in the Liver Paired Exchange program. This program was started to increase the chance for potential living liver donors who are approved to be liver donors but who can’t donate their liver to their original intended recipient for various reasons. The program involves two incompatible pairs, which become compatible pairs by “swapping.”

You and your donor will have surgery at the same time. Cleveland Clinic is one of the few places — and the most active center in the United States — to offer minimally invasive surgery for living donors.

Minimally invasive laparoscopic donor surgery

At Cleveland Clinic, we use minimally invasive laparoscopic donor surgery (keyhole surgery) instead of traditional (open) surgeries. During open surgery, the surgeon has to make a large incision (cut) in the donor’s belly to remove part of their liver. Doing a minimally invasive procedure means much smaller cuts. Laparoscopic techniques reduce the risk of bleeding, resulting in smaller scars and speeding up the donor’s recovery.

Your surgeon will use a thin, telescopic rod with a camera attached to it (laparoscope) to see inside your abdomen. They’ll make several small incisions (usually up to five) to do this. One is for the camera and the others are for the surgical tools your surgeon will use during the operation.

Patients usually require only half the amount of pain medication and recover twice as fast compared to those who’ve had open surgery.

Your provider will let you know before surgery how long you’ll need to stay in the hospital after your operation.

Deceased donor liver transplant

Liver transplants from donors who’ve died make up the majority of these surgeries. All liver transplant candidates will join the national waiting list to get matched with a donor’s liver.

A lot of factors come into play to find the right match for you — things like how sick you are, your body size and your blood type.

This means you could wait a few days, months or even several years for a new liver match. And joining the list doesn’t guarantee you’ll get a deceased donor liver — although the sicker you are, the faster you can move higher up on the list. Your provider will talk with you about how the list works and what to expect.

If and when a matching liver becomes available, things will move fast. You’ll need to come in right away. When you get there, you’ll get some standard health screenings and meet with your surgeon and anesthesiologist to start preparing for surgery.

Ex vivo liver perfusion

Cleveland Clinic was the first hospital in the U.S. to transplant a human liver using ex vivo liver perfusion. You might be thinking “what is that and how is it different?” This is a groundbreaking new technology that lets our surgeons extend the life of livers that weren’t safe to use in the past. How does this work? We use a machine to pump blood through the donated organ — keeping it warm. Using this technique increases the number of organs available for transplant surgery. This shortens the waiting time for patients and saves more lives.

Adults aren’t the only ones who might need a liver transplant. Some kids also do, and Cleveland Clinic Children's is here to help them and their families during this stressful time.

We have one of the most experienced pediatric liver transplant teams in the country, with certified pediatric transplant hepatologists and surgeons at the ready. Your child will have the same team of providers from the time of referral and beyond.

During the first visit, you and your child will meet with their whole team. We’ll go over all the treatment options and what to expect throughout this journey. Your child will have a physical exam and some bloodwork done so our team can get a better idea of their overall health and how far their liver disease has progressed.

Pediatric liver transplant surgery requires special skill sets to make it successful because children aren’t small adults. Your child will receive a smaller portion of a liver from a live or deceased donor or a whole liver from a deceased donor of a matching size.

Pediatric transplant pharmacists, dietitians, psychologists and social workers are also part of your child’s care team. Throughout the whole process, we’re there to support you and your child — treating the whole person, not just the liver.

Typically, you’ll be in intensive care for a few days while your providers keep an eye out for any complications. After leaving intensive care, you’ll typically stay another one to three weeks in the hospital to continue your recovery.

Your provider will talk with you about how long you’ll need to stay in the hospital and in the area after your transplant. This depends on how sick you were before your transplant and if you’re having any problems after the operation.

The promising news is that when discharged, most patients walk out our doors and eventually return to their daily activities — often in three months to less than a year. If you need more medical support, you may stay in a rehabilitation facility before going home to help get your strength back. But our care doesn’t stop when you leave. We’re here to support you throughout your entire journey, from your first visit — and beyond.

When you go home, you’ll follow up with your providers often, in-person or through virtual visits, and get regular blood tests. You’ll also take medications to help you recover and prevent your body from rejecting your new liver. You’ll need to take some of these medications for the rest of your life. You’ll work with a post-transplant coordinator who’ll keep in touch with you and look at your lab work, help you with appointments and more.

Mental, emotional and spiritual support

If you feel like you need to talk to someone about how you’re feeling emotionally at any point during your transplant journey, we can also connect you with mental health counselors, social workers or a spiritual advisor. We also have American Liver Foundation and TRIO (Transplant Recipient International Organization) support groups.

Traveling for liver transplant surgery

Traveling for liver transplant surgery can put a whole other level of stress on the process. We understand that. If you’re coming to us from another city, state or even another country, we’re here to help make things as easy and convenient as possible for you. We can give you recommendations on where to stay, where to eat and shop, and how to get to and from the airport or just find your way around any of our hospitals.

If you’re an international patient, our experienced and compassionate Global Patient Services (GPS) team will help you navigate the Cleveland Clinic health system. They’ll connect you with the healthcare providers you need, help make appointments, provide language translation services and coordinate follow-up care when it’s time to go home.

Taking the Next Step

Preparing to get a liver transplant can be overwhelming — and life-changing. But you don’t have to go through it alone. Our experienced team of healthcare providers is here to help answer your questions and create a personalized treatment plan for you. We’ll help you find the right donor liver and get you on the road to recovery so you can enjoy life again. We know it’s a long journey. That’s why we’ll provide compassionate care and support every step of the way.