FAQs

American Liver Foundation’s (ALF) Living Donor Network is the first-ever non-directed liver donor database; it was created to connect individuals who wish to donate part of their liver with transplant centers nationwide to help patients in need. The ALF Living Donor Network is a pivotal step in addressing the critical shortage of liver donors in the U.S. It not only increases the donor pool but also offers a lifeline to patients who might otherwise face prolonged wait times on a deceased donor list leading to potential decline in health or even death.

Most living donors know the person they would like to donate part of their liver to; this is called directed donation. There is, however, an increasing number of individuals who would like to provide the gift of life to someone in need, whom they do not know. These individuals are known as non-directed donors (NDD), formerly called altruistic donors.

With nearly 9,300 people in the U.S. waiting for a liver transplant right now, the need for living donors is great. Approximately 25% of people on the liver transplant list will die waiting due to lack of available organs. Living donor liver transplant offers a solution, but despite being an available treatment option for decades, it continues to lag far behind living donor kidney transplant. According to the Organ Procurement and Transplantation Network (OPTN), in 2024 there were 11,458 liver transplants in the U.S. and only 604, or 5.27% were from living liver donors. That same year living kidney donors made up about 23% of all kidney transplants.

Studies show that public willingness to donate an organ to strangers is growing, with up to 22% of individuals surveyed open to becoming a living donor. However, many transplant centers lack structured outreach for such donors. The ALF Living Donor Network offers non-directed liver donors an easy and secure way to connect with transplant centers across the country.

Our goal is twofold: increase the number of living donor liver transplants for adults and children in the U.S.; and eliminate the pediatric liver candidate waitlist.

The ALF Living Donor Network is voluntary and open to anyone who would like to become a non-directed liver donor. Registrants must be 18 years of age or older and reside in the U.S. Download the Quick Start Guide here.

Non-directed living liver donors can dramatically expand lifesaving liver transplants, especially for patients who cannot find a living donor or a match from family or friends. By registering to become a non-directed liver donor, you have potential to give someone the gift of life.

If you choose to register as a non-directed living liver donor, click the REGISTER NOW blue button in the top right corner of this webpage. You will complete an online health history questionnaire, consisting of 13 core medical sections. Once you’ve completed the questionnaire, the system will evaluate your submission to determine eligibility. If eligible, you will be referred to a transplant center for further evaluation. Donors have the ability to choose which transplant center they would like to be referred to as part of the initial questionnaire.

• The information you share will help us understand if you might be a good match to be a living liver donor.
• Your answers will be compared to the guidelines that transplant programs in the ALF Living Donor Network typically use to evaluate donor candidates.
• This is an early step to see if living donation could be a safe and possible option for you.
• If you seem like a potential match, a transplant center may reach out to you for the next steps.
• Sharing your information doesn’t mean you’re committing to donate or that you’ll definitely be contacted — it just helps us start the process.
• Please view the complete terms of use available here.

When transplant centers evaluate potential living donors, the donor’s health is the number one priority. Transplant centers use certain criteria to ensure a donor’s health will not be compromised through the selfless act of organ donation. If you are not accepted as a donor, your journey to help liver patients doesn’t have to end there! Your voice is powerful and using it to raise awareness about living donation is one of the most important ways you can help advance the field and help more patients find a match.

Consider sharing ALF’s comprehensive Living Donor Liver Transplant Information Center with your social media networks. This free resource includes information for those looking to find a living donor, resources for those considering donation, a complete toolkit with educational information for donors and recipients, and a series of 60-second videos about the living donor liver transplant process. You can also become a Liver Life Advocate® and help us expand access to care and increase living donor protections on Capitol Hill.

Even if you are ineligible to donate a portion of your liver to someone in need, you have already shown such courage and strength to help liver patients! Your voice is powerful—raising awareness about living donation save lives.

Click on the REGISTER NOW blue button on the top right corner of this webpage. Download the Quick Start Guide for additional information and tips. 

Living donor liver transplantation is a surgical procedure where a healthy person donates a portion of their liver to a child or adult in need. This is possible because the liver is the only organ in the human body that can regenerate—both in the donor and the recipient—within a few months. Learn more about the process in this 60-second animated video.

By being a living donor, you have the opportunity to give someone a second chance at life. Not only will you change the course of the recipient’s life, but the course of their loved ones’ lives as well.

Each transplant center may have slightly different criteria, however there are some basic requirements you should meet if considering liver donation:

• Age: Over 18 years old
• Health: In excellent physical and mental health
• BMI: Typically, under 35
• Blood type compatibility with the recipient
• No significant medical conditions (e.g., liver disease, heart disease, diabetes)
• Non-smoker or willing to quit before surgery
• Willing and informed, with no pressure or coercion
• Strong support system for recovery

If you qualify as an eligible donor, you will be connected with a transplant center for a full transplant evaluation to ensure optimal safety for you and the recipient which includes:

• Blood tests & imaging to check overall health, liver anatomy and blood type compatibility
• Psychological assessments to confirm you understand your risk and are donating voluntarily
• Consultations with hepatologists, transplant surgeons, social workers and sometimes nutritionists to ensure you are a good candidate and have adequate support at home.

If you are a qualified candidate, your transplant center will go over any specific risk factors you may have during your formal transplant evaluation. The long-term health risks of living donation for someone determined healthy enough to donate are low, however, like any surgery there are some immediate risks which may include:

• Allergic reaction to anesthesia
• Injury to tissues or other organs
• Infection
• Blood clots
• Bleeding
• Pneumonia

Yes! Caring Connections–an ALF peer to peer support program can connect you with a living donor mentor. Through ALF’s online peer mentoring
platform, you are matched, one-to-one, with a trained peer mentor and can communicate safely and securely by messages or video chat. The platform makes it easy to share your questions, experiences, and challenges with a trusted peer who understands what it’s like to be in your shoes. To join this free program now, head to liverfoundation.org/caringconnections.

Yes, living liver donation is a viable and safe option after kidney donation. The transplant team will carefully review your medical information and evaluate whether liver donation after kidney donation is an option for you.

The recipient’s insurance usually covers a living donor’s medical expenses, including evaluation, surgery, and follow-up care. However, non-medical costs like travel, lodging, meals, and lost wages are not typically covered. While donors cannot be paid, recipients or charitable programs may help cover these expenses. Organizations such as National Living Donor Assistance Center (NLDAC), which operates the Living Organ Donation Reimbursement Program (LODRP), can currently assist non-directed donors with their travel expenses, lost wages and dependent care, regardless of their recipient’s income. Read a summary of the program here, or learn more by watching these two insightful videos: Introduction to NLDAC and How to Apply.

Typically non-directed, or altruistic, donors are individuals who give the gift of life to someone they don’t know, however, you do have the opportunity within the ALF Living Donor Network to choose between a child or adult transplant center. In addition, to ensure ALF’s neutrality in referring donors to transplant centers, donors will be encouraged to choose the transplant center based on the following criteria: where you live, where you may have friends or family who can help care for you during and after a liver donation, or where you are able and comfortable traveling for a transplant evaluation and surgery. If you are open to donating to either a child or an adult, centers will aim to allocate the liver lobe to the recipient that needs it the most. Also, if you are aware of a patient actively looking for a living donor (i.e. through an online social media campaign, news article, etc.), you may enter that person’s name into your questionnaire.

Please note: A donor who identifies a specific recipient may not be able to qualify for the same level of financial assistance from the National Living Donor Assistance Center (NLDAC) as the recipient’s income is assessed prior to the donor being approved.

Unless you and the recipient agree to exchange information, the process will remain entirely anonymous. If you and your donor choose to meet or exchange emails, your transplant center can help arrange that for you.

The decision to become a living donor (or not) is yours to make – you should never be pressured by anyone to donate. Your safety and wellbeing are of utmost importance. Once you are accepted as a donor there are multiple steps along the way to ensure that you are still comfortable in going forward with donation.

To find out more about living donor liver transplants, please visit our Living Donor Liver Transplant Information Center.