Living Liver Donation and the Chance of Liver Failure

What is liver failure?

Liver failure is a life-threatening condition that means your liver isn’t working well enough to do its job, such as to make bile (fluid to help you digest food) and remove harmful substances from your body. It very rarely happens in living liver donors.

If I donate a liver, will I have a higher chance of liver failure?

You’ll have a slightly higher chance than if you don’t donate. But, liver failure in living liver donors is rare.

Right lobe donors (who donate 50-70% of their liver) are more likely to have health issues than left lobe donors, which is smaller. Minor to severe health problems happen in 24-40% of right lobe donors. Most of these problems are minor and short-lived. Data shows only 6 of every 10,000 (0.06%) right lobe donors had liver failure that required a liver transplant (from the United Network for Organ Sharing (UNOS)).  

How do transplant teams lower the chance of liver failure in donors?

To lower the chance of liver failure after the donor surgery:

  • Before surgery, skilled radiologists and the surgeons review accurate, high-quality imaging tests (CT scan or MRI) of the liver to understand how to safely split the liver and remove a part for transplant
  • The surgeon always strives to leave at least 30% of the donor’s liver in their body so it can grow to meet their body’s needs (and more than 30% for some donors, such as older donors or those with fatty liver changes)

How can I learn more?

To learn more about donation surgery and possible problems:

  • Talk with your transplant team
  • See Chapter 4 on living liver donation and possible surgery problems




  1. Rössler F, Sapisochin G, Song G, et al. Defining Benchmarks for Major Liver Surgery: A multicenter Analysis of 5202 Living Liver Donors. Annals of surgery. 2016;264(3):492-500.
  2. Roll GR, Parekh JR, Parker WF, et al. Left hepatectomy versus right hepatectomy for living donor liver transplantation: shifting the risk from the donor to the recipient. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2013;19(5):472-481.
  3. Abecassis MM, Fisher RA, Olthoff KM, et al. Complications of living donor hepatic lobectomy--a comprehensive report. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2012;12(5):1208-1217.
  4. Organ Transplantation and Procurement Network Policy 18.5. Accessed June 10th, 2021.



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 kidney 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