What Happens After Organ Donation? Critical Journey of Heart, Liver, Kidney Explained

What happens to a donated heart, liver or kidney before transplant? Discover how organs are recovered, preserved, transported and prepared for surgery in a race against time.

When a liver is donated for transplantation, a carefully coordinated race against time begins. From organ recovery to transplantation, every step is crucial. The aim is to protect the liver, preserve its function, and deliver it safely to the recipient whose life depends on it.

Once donation is approved, a specialized surgical team at the South Asian Liver Institute carefully retrieves the liver. Immediately after recovery, the organ is flushed with a cold preservation solution. This removes blood and rapidly lowers the liver’s temperature, slowing its metabolism and reducing the risk of cellular injury.

The liver is then thoroughly examined. In our case, Prof. Dr. Tom Cherian assesses its size, appearance, blood vessels, bile ducts, and overall condition. The donor’s medical history, blood group, laboratory results, and other relevant information are reviewed to determine whether the organ is suitable for transplantation.

After assessment, the SALI team places the liver in sterile, protective packaging and transports it under controlled cold conditions. Meanwhile, the transplant team prepares the recipient. Blood tests are confirmed, the operating theatre is readied, anesthesia arrangements are completed, and the surgical team prepares for the procedure.

Traditionally, liver grafts are preserved through cold storage. Keeping the organ cold significantly reduces metabolic activity and helps protect its cells. However, preservation time is limited. The longer the liver remains without normal blood flow, the greater the risk of injury after transplantation. Efficient transportation, communication, and surgical preparation are therefore essential.

Some transplant centers use machine perfusion technology to further support organ preservation. At SALI, however, conventional cold preservation is used. Prof. Dr. Tom Cherian’s extensive experience, including more than 800 liver transplants, allows the team to manage the process effectively while also avoiding the additional costs associated with machine perfusion.

When the liver reaches the transplant centre, it undergoes a final inspection. If deemed suitable, transplantation begins. The recipient’s diseased liver is removed, and the donated liver is carefully positioned. Surgeons connect the major blood vessels and bile duct. Once blood flow is restored, the liver begins functioning in its new body.

Behind this remarkable journey is a dedicated team of surgeons, transplant coordinators, anesthetists, nurses, laboratory professionals, and transport personnel.

A donated liver is not simply transported between hospitals. It follows a carefully planned journey in which every minute matters. Ultimately, this race against time protects something priceless: the donor’s gift and the recipient’s opportunity for a new life.

-This article is authored by Prof. Dr. Tom Cherian, Founder & Managing Director. South Asian Liver Institute. Liver Transplant Surgeon, Manipal Hospital's Vijayawada