Liver transplantation · For the donor
If I give part of my liver, what happens to me?
This is the question every living donor deserves a straight answer to — with numbers, not reassurance. Here is what international data shows, how the liver recovers, and the protections Turkish law gives you.
The short answer
- In a worldwide survey of 11,553 living liver donors, the risk of death was 0.2% — about 1 in 500. That is higher than for kidney donation, and you are entitled to know it.
- You always keep at least 30% of your liver.
- The liver regrows: by three months, the remaining liver reaches on average 80% of its original volume.
- For most donors, quality of life is back to the level of the general population by six months.
- In Turkey, every living donor centre must have an independent living donor rights advocate whose only job is to protect you.
The centre's first duty is to you
The patient is already ill. You are healthy. The international guideline on living liver donation sets out three things the evaluation must establish before anyone operates:
- That a large enough part of your liver can be removed safely for you.
- That there is no risk of passing a disease to the recipient.
- That you understand the process and would be able to cope with its psychological consequences.
If any one of these is not met, the answer should be no — however much the family wants the transplant to happen.
How much liver is taken
The liver has a larger right side and a smaller left side. An adult recipient usually needs the right side, because the transplanted part must be big enough: generally more than 40% of the recipient's expected liver volume, or more than 0.8% of their body weight.
But the donor must keep enough to live on safely. Guidelines require that the part left behind is at least 30% of the donor's original liver. For donor safety, centres use the smaller left side whenever it is large enough.
If giving the recipient enough liver would leave you with too little, you are not a suitable donor — even if you are healthy and fully compatible. This is not a failure. It is the rule working as it should.
The risk, stated plainly
The largest study of living liver donor safety surveyed transplant programmes in 21 countries, covering 11,553 donor operations:
| Outcome | Rate |
|---|---|
| Donor death (most within 60 days) | 0.2% — 23 of 11,553 |
| Potentially life-threatening "near-miss" event | 1.1% |
| Operation stopped part-way and the donation abandoned | 1.2% |
Giving part of a liver is a bigger operation than giving a kidney, and the risk is higher. Any centre that tells you the risk is zero is not being honest with you.
Does the team's experience change the risk?
The donor death rate was similar across programmes. But near-miss events and abandoned operations were more common in programmes that had performed 50 or fewer living donor transplants.
In Turkey, the legal minimum for a liver transplant centre is 5 transplants a year. That is a floor, not a standard. Ask the centre directly how many living donor liver transplants it performs each year.
After donation: the long term
A 2025 review of long-term follow-up studies reported these problems among living liver donors. The ranges are wide because the studies measured them differently:
| Long-term problem | Reported in |
|---|---|
| Discomfort at the incision site | 13.2% – 38.8% |
| Narrowing of the bile ducts | 1% – 14% |
| Hernia at the incision | 0.6% – 8.4% |
| Psychiatric problems (such as depression or anxiety) | 1% – 22% |
The more encouraging finding: six months after donation, most donors' quality of life matched that of the general population. It stayed lower mainly in two groups — donors whose recipient died, and donors who came to regret the decision. That is why psychological preparation before donation, and support afterwards, matter as much as the surgery.
The liver grows back
Unlike a kidney, the part of the liver that stays behind regrows. In a large North American study of 350 donors, the remaining liver had reached on average 80% of its original volume within three months. The part given to the recipient grew too — to 93% of the expected size.
Your transplant team will give you a personal timeline for hospital stay, returning to work and returning to exercise. Ask for it before you decide, not after.
Your rights as a donor in Turkey
| Protection | Legal basis |
|---|---|
| No one may take or sell an organ for money or any other benefit | Law 2238, Article 3 |
| The donor must be an adult able to make their own decision | Law 2238, Article 5 |
| Consent in writing, before two witnesses, confirmed by a doctor | Law 2238, Article 6 |
| If the donor is married, their spouse must confirm in writing that they know about the decision | Regulation, Article 12 |
| Donors who are not a spouse or close relative need ethics committee approval — and its decisions can be appealed within 15 days | Regulation, Articles 12 and 15 |
| An independent living donor rights advocate at every living donor centre | Regulation, Article 16 |
| The centre must inform donors about their follow-up check-ups | Regulation, Article 34 |
Every centre in Turkey that performs living donor transplants must appoint a person whose role is to protect and defend the donor's medical and ethical rights. This person is a psychiatrist, psychologist, certified transplant coordinator or social worker, works independently, and answers to the Ministry of Health — not to the transplant team.
If you feel pressured by anyone — family, the recipient, or the hospital — this is the person to tell.
"If you give part of your liver, you live with half a liver for the rest of your life."
The liver regrows. Within three months, the remaining part is on average back to around 80% of its original size.
If you are the patient's relative and wondering whether you would be allowed to donate at all, see who can legally be a donor in Turkey.
Medically reviewed by Prof. Dr. Murat Tuncer
Nephrologist and transplant physician. This guide was prepared by the BookingHospital medical team from international liver transplantation guidelines, published studies and Turkish legislation.
Thinking about donating? Ask before you decide
Send us your own test results — not the patient's. We will tell you honestly whether you are likely to be a suitable donor, including when the answer is no.
Medical and legal disclaimer. This article is general information based on published guidelines, studies and Turkish legislation as of September 2026. It is not personal medical or legal advice, it does not establish a doctor–patient relationship, and it cannot replace assessment by a transplant team. Donor suitability is decided after detailed medical, surgical and psychological evaluation.
References
- Miller CM, Durand F, Heimbach JK, et al. The International Liver Transplant Society Guideline on Living Liver Donation. Transplantation 2016;100(6):1238–1243.
- Miller CM, Quintini C, Dhawan A, et al. The International Liver Transplantation Society Living Donor Liver Transplant Recipient Guideline. Transplantation 2017;101(5):938–944.
- European Association for the Study of the Liver. EASL Clinical Practice Guidelines on liver transplantation. J Hepatol 2024;81(6):1040–1086.
- Cheah YL, Simpson MA, Pomposelli JJ, Pomfret EA. Incidence of death and potentially life-threatening near-miss events in living donor hepatic lobectomy: a world-wide survey. Liver Transpl 2013;19(5):499–506.
- Olthoff KM, Emond JC, et al. Liver regeneration after living donor transplantation: adult-to-adult living donor liver transplantation cohort study. Liver Transpl 2015;21(1):79–88.
- De Carlis R, Di Lucca G, Lauterio A, Centonze L, De Carlis L. The long-term follow-up of the living liver donors. Updates Surg 2025;77(6):1767–1775.
- Republic of Türkiye. Law No. 2238 on the Removal, Storage, Grafting and Transplantation of Organs and Tissues.
- Republic of Türkiye, Ministry of Health. Organ Transplantation Services Regulation. Official Gazette No. 32038, 9 December 2022 (as amended).
