Liver Transplant + Living Liver Donor

If you or someone you love has liver disease, a liver transplant may be an option. Some liver conditions cause lasting damage. When the liver can no longer work the way it should, a transplant may help.

At Tufts Medicine, we care for people with many types of liver disease. We explain all transplant options, including deceased donor and living donor liver transplant. A living donor transplant may be an option for some conditions, depending on your health and timing. We help you understand what may be right for you and what steps come next. Below are some conditions that may lead to a liver transplant:

• Acute liver failure: Sudden loss of liver function, often due to infections or toxins (e.g., acetaminophen/Tylenol).
• Alcohol-related liver disease: Caused by long-term heavy alcohol use, leading to inflammation and scarring of the liver.
• Alpha-1 antitrypsin deficiency: An inherited disorder that can lead to liver disease and cirrhosis and may affect the lungs.
• Autoimmune hepatitis: A condition where the immune system attacks the liver, causing inflammation and liver failure.
• Bile duct cancer (cholangiocarcinoma): Cancer of the bile ducts that may require a liver transplant in some cases.
• Biliary diseases: Conditions affecting the bile ducts that may lead to liver damage or cirrhosis.
• Cirrhosis: Severe liver scarring caused by long-term liver damage; a leading cause of liver transplant.
• Colon cancer with liver metastases: When colon cancer spreads to the liver, a transplant may be considered in certain cases.
• Hemochromatosis: An inherited condition where the body stores too much iron, damaging the liver and other organs.
• Hepatitis B and hepatitis C: Chronic viral infections that can cause liver inflammation, cirrhosis or liver cancer.
• Liver cancer (hepatocellular carcinoma): A type of liver cancer that may be treated with a transplant if it’s confined to the liver.
• Metabolic dysfunction-associated steatotic liver disease (MASLD): Previously called non-alcoholic fatty liver disease (NAFLD); related to obesity and other metabolic conditions that can lead to cirrhosis.
• Polycystic liver disease: Growth of fluid-filled cysts in the liver, often tied to polycystic kidney disease.
• Primary biliary cholangitis (PBC): A chronic disease that destroys the small bile ducts, leading to cirrhosis.
• Primary sclerosing cholangitis (PSC): A long-term condition that scars and narrows the large bile ducts and is often linked to ulcerative colitis.
• Wilson disease: A rare inherited disorder causing copper buildup in the liver and other organs, which can lead to liver failure.

Supporting those in early sobriety with alcohol-related liver disease

We offer a dedicated transplant pathway for people with alcohol-related liver disease who are newly sober. This program recognizes the work it takes to make a change and provides clear support during the transplant evaluation process.

Our liver transplant doctors, mental health specialists and social workers work as one team. We focus on medical care, emotional health and long-term stability to help you move forward toward transplant. This approach may allow earlier transplant consideration while supporting recovery and overall health.

Participation requires a referral from your doctor. Our team works closely with you and your care providers every step of the way.

Before a liver transplant, you’ll have a series of tests to make sure you’re ready for surgery and to find the best donor match. At Tufts Medicine in Boston, we’ve streamlined the usual 6-day evaluation into just 2 days. This makes the process more efficient while still giving you thorough, expert care.

During these 2 days, you’ll meet with different specialists and complete all necessary tests. Our team will be available to answer questions and introduce you to the professionals who will support you throughout your transplant journey.

Evaluation: Day 1

• Patient and family education session
• Consult with a transplant surgeon
• Consult with a transplant anesthesiologist
• Consult with a transplant nurse coordinator
• Consult with a transplant pharmacist 

Evaluation: Day 2

• Consult with a transplant social worker
• Consult with a transplant infectious disease physician
• Consult with a transplant dietitian
• Consult with a transplant psychiatrist

Additional testing may be recommended based on your 2-day evaluation. This helps our team ensure your transplant is as safe and effective as possible.

If you have end-stage liver disease or sudden liver failure, a liver transplant may be the best option. This surgery replaces your diseased liver with a healthy one from a donor. It’s a complex procedure that requires careful planning and a skilled team to ensure the best results.

Finding a matching liver donor can be challenging because of strict compatibility requirements. At Tufts Medicine in Boston, we are accredited by the Organ Procurement and Transplantation Network (OPTN), which ensures fair and safe organ allocation. We also partner with United Network for Organ Sharing (UNOS), which manages transplant data nationwide.

Transplants may come from a deceased donor or, in select cases, a living liver donor, which can help reduce wait times and allow for better planning. Our team will guide you through the process, explain your options and help you understand the next steps.

What to expect during a liver transplant

• Finding a liver donor: Once approved for transplant, our team works to find the best donor match. Deceased donor livers come from people who have passed away and donated their organs respectfully. Living liver donors may also be an option for eligible candidates.
• Liver transplant surgery: During surgery, your diseased liver is removed and replaced with the donor liver. The procedure usually takes 2–4 hours under general anesthesia. You will be closely monitored throughout surgery.
• Post-surgery care and recovery: After surgery, you’ll stay in the hospital for 3–5 days for monitoring and support. Our team manages pain, watches for complications and starts medications to prevent your body from rejecting the new liver.
• Follow-up care: Once home, you’ll have regular check-ups to monitor your liver and adjust medications. Over time, visits become less frequent as your recovery progresses.
• Lifestyle and medications: You’ll take immunosuppressant medications to prevent rejection. These are usually steroid-free to reduce side effects. A healthy diet, regular exercise and following your care plan help your new liver heal and function well.

At Tufts Medicine, we guide you every step of the way, supporting your recovery and helping you return to daily life.