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Liver Transplant + Living Liver Donor

Tufts Medicine in Boston provides comprehensive care for people with liver failure, including living donor liver transplants and transplants from deceased donors. We guide you through every step, from evaluation and surgery to recovery and follow-up.

Our 2-day evaluation streamlines testing and consultations so you can start your transplant journey quickly and confidently. Living donor liver transplants give patients more options and shorter wait times, while ensuring both donor and recipient can recover safely.

Giving second chances with liver transplants + changing lives with living liver donation

At Tufts Medicine, we specialize in liver transplants and guide you through every step with expert care. Whether you need a transplant because of a long-term liver condition or sudden liver failure, we help you understand all available options, including deceased donor transplant and living liver donation. Our team takes the time to explain what each option means and what next steps may look like, so you feel informed and confident in your care.

If living liver donation may be an option for you, we help you explore that path and understand the evaluation process. We work closely with you and your support system to answer questions and coordinate care as needed.

After transplant, we continue to provide expert follow-up care. We monitor your progress, manage medications and support healing to help you return to daily life safely. At Tufts Medicine, we provide personalized, compassionate care focused on supporting you throughout your liver transplant and liver donation journey.

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Conditions

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.

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Testing

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.

Expert care for your liver transplant at Tufts Medicine

At Tufts Medical Center, our experienced liver transplant team is here to support you. Led by Dr. Fredric D. Gordon and Dr. James Pomposelli, we have experts in hepatology, surgery, nutrition and more, all working together for your success. From evaluation to recovery, we provide the care and support you need every step of the way.

When you choose Tufts Medicine for your liver transplant, you’re choosing a team of highly skilled professionals committed to your success and well-being. We’ll guide you through the entire process, providing the support you need for a smoother journey toward recovery.

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Treatments

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.

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Become a living liver donor

Living liver donation can save lives for people waiting for a liver transplant. At Tufts Medicine in Boston, we offer living liver donation as a way to give someone a second chance while allowing you to continue living a healthy life.

During living donation, a person donates a portion of their liver while healthy. The liver is unique because it can regrow — both for the donor and the recipient. Within a few months, both livers return to normal size and function.

If you’re interested in becoming a living liver donor, start by filling out our online screening form. If you qualify, our transplant team will contact you to explain the next steps and guide you through the entire process.

FAQs

Who can donate part of their liver?

You must be at least 18, in good physical and mental health, and fully understand the risks and benefits of donation. Our team will help you decide if living liver donation is right for you.

Does blood type matter for living liver donation?

Yes. Donor and recipient blood types must be compatible. We perform blood and tissue tests to confirm compatibility. If you’re not a match, you may still help through a “swap” or altruistic donation program. You don’t need to know your blood type before applying.

What should a donor expect during evaluation?

Donors visit Tufts Medical Center in Boston for a check-up and detailed testing. Some tests, like bloodwork, can be done closer to home. Before coming in, you’ll meet with an Independent Living Donor Advocate (ILDA) to ensure you feel no pressure and understand you can change your mind. Testing includes lab work, imaging and a full health assessment. Afterward, our team reviews results and discusses next steps.

How is the donor evaluation paid for?

The recipient’s insurance covers your evaluation, surgery and follow-up visits. Costs like travel, lodging and lost wages are usually not covered. Some programs, like the National Living Donor Assistance Center, may help based on income. Our social work team can help you find available support.

What happens during surgery?

Doctors remove a portion of your liver — usually the right or left lobe — and transplant it into the recipient during the same procedure. Surgery lasts several hours and donors typically stay in the hospital for about a week. Your liver begins to grow back immediately, reaching near full size in a few months.

What happens after donation?

Most donors return to light activity in a few weeks and can return to work in 6 to 8 weeks, depending on the type of job. Our team provides regular follow-up visits and imaging to make sure your liver heals well. Donors may feel sore or tired for a short time, but most regain normal energy as their liver regenerates.

Why consider living liver donation?
  • Shorter wait time for a transplant
  • Ability to plan surgery when both donor and recipient are ready
  • Excellent organ quality and strong outcomes
     

For referring physicians

At Tufts Medical Center in Boston, we value the trust you place in us when referring patients for liver transplant care. We partner with you throughout the entire transplant process—before, during and after surgery—to ensure seamless, coordinated care.
Our experienced team includes hepatologists, oncologists, interventional radiologists, anesthesiologists, nurse coordinators, social workers, pharmacists, psychiatrists, infectious disease specialists and nutritionists. Together, we provide comprehensive support for your patients at every stage.

Key benefits and resources:

  • 24-hour patient placement access line for urgent needs and inpatient referrals: 877.658.8387
  • Dedicated nurse coordinator to guide you and your patient through the transplant journey
  • In-house histocompatibility and immunogenetics laboratory (HLA Lab)
  • Specialized inpatient transplant units for pre- and post-transplant care
  • Intensive care units and inpatient transplant surgery services
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