Should I donate part of my liver to my sister?

This is an awful dilemma to be facing and I really feel for you. Personally I would not donate, as I would prioritise my children first - on the grounds that they will need you to be healthy for them, and secondly, if anything were to happen to your children in future you might need to be able to donate to them.

Will she be disciplined enough to take the anti rejection meds every day for the rest of her life?

Are you sure your sister is well enough to undergo a transplant ?
Are you her Next of Kin ? Have you had discussions with the ITU doctors?
It's a very distressing situation but you may find that the decision is taken out of your hands as if your sister is also on dialysis, it sounds as if she has multi-organ failure.
It's horrendous for you , having been in a similar situation I can fully empathise.

I wouldn't donate. My children would be my priority. I'd be concerned that she'd either start drinking again or not look after herself and it would all go to waste.

I think your priorities are distorted, you feel unable to ask your family to take any kind of a hit for you and yet you are prepared to take this massive hit for your sister
It's as if you don't value yourself

The living donor process is complex and there’s a lot of psychological support etc. It’s been a good few years since I worked in a hospital that did liver transplants but at the time they didn’t support family members donating when the patient was incredibly sick - there are different levels of urgency for liver transplants and they only did living donor ones when the patient was relatively stable and there was enough time to go through all the psychological assessments (of both the patient and the donor) - I don’t think it would be feasible when your sister is so unwell

I dont think my sister is strong enough for a transplant. But I dont think there is much other choice for her.

I don't think you're at the place yet where you can debate this, even theoretically.

It could be that she's not a candidate for surgery, if she's as weak as you suggest. They won't do that surgery if she's not likely to survive it.

It could be that the prognosis if she does have it isn't what you hope for, depending on other damage to her body/organs.

It could be that she won't go through with the surgery anyway, or that you're not a match.

You need to know that she's a candidate for surgery, when it would happen, what the prognosis would be, and whether you're a match. Then you can weigh up the risks with the benefits. That's the only way that you can approach this.

She's your sister, so your parents must be part of the decision making process and, as they have the means to support you and your children until you are better, that is their contribution to your sister's recovery.

I would speak to her doctor first, to see if it's even feasible before raising anyone's hopes.

She sounds extremely poorly, and sadly I would wonder if she would survive a transplant.

Whatever you decide I think you should make that decision fully informed, can you perhaps arrange to speak to her doctors, and discuss the transplant process in general terms? See if it actually a possibility? Then you can decide when you have all the necessary information in front of you. Whilst I have every sympathy with your sister, you have to do what's right for you and your DC. Unfortunately she has made her choice through the years, although I appreciate how destructive an addiction is.

I wouldn’t donate my liver to an alcoholic. Alcoholics are addicts and may return to their damaging habits if they’re stressed. I’m really sorry to hear about your sister’s health. You need to go through different tests to check you’re a match and that you’re healthy enough to go through major surgery. You have to think of the recovery time and potential damage during surgery.

I think you need to speak to her doctors at the hospital you might be hanging on to a hope or putting yourself through terrible angst over a decision on something that is no longer possible. With the condition you say she is in I would make the call today, asking the questions commits you to nothing but I think you will regret it so much if you don’t at least ask the questions now.

Also, do the doctors think she could go through surgery? She sounds very poorly and malnourished.

Can one of your parents donate instead? Or is there an age limit? I don't fully know the ins and outs of it.

Does your sister have children? (sorry if you've said and I've missed it) I think that would heavily influence my decision.

Has she even been referred for transplant assessment? She doesn't sound anywhere near well enough to make it onto transplant list.

Living donors are at risk of dying from the surgery. There are far greater risks involved than 3 months of financial pressure. Your children could lose their mother.

I'm sorry for what you're going through.

This must be so difficult for you. I would have to weigh up the risk vs benefits.
What is the prognosis for your sister after the transplant? Could she improve significantly?

I'd mainly be worried about your health. Being a donor is major surgery and no guarantees of a return to full fitness. You must make sure you go into this with your eyes open.

No! Please don't do this to yourself for someone who doesn't deserve it.

Find out if she’s dry, committed heart and soul to sobriety forever and most critically is actively engaged in an alcohol recovery program such as AA with a mentorship or Smart Recovery. She needs to be signed up and attending the sessions.....about 3 times a week without fail. It has to come from within though.....it’s not something you can demand from her or police. Anything less than this is lip service and knowing the half truths that drinkers spin, is not worth you putting your life on the line for OP.

"The only real risk to you is that which comes from any surgery. (Pretty small compared to your sisters chances of dying)"

Would it not make her vulnerable to Covid?

Living donors are at risk of dying from the surgery
Makes me think of the film 'never let me go' ☹️

Sadly, I think if sibling donation was a viable option your sisters medical team would have already raised it with you.

Instead of theorising, ask for a confidential discussion with them. It will be the fastest way to an answer, and relieve the burden of thinking about a decision which may not even be on the table as a possibility.

My DM was a heavy drinker for many years. Has been in AA for 15 years now. There is not a cat in hells chance I would say yes to this.

I clicked on this thread thinking OF COURSE why wouldn't you?!

But actually...your sister doesn't sound well enough for the procedure, and it sounds like it would be all but impossible for you, in practical terms.

You need to have a conversation with her consultant, because if she's not able to undergo the surgery, you could be torturing yourself unnecessarily.

Not easy at all.

All I'm sure of is that, if you do end up donating, your parents/sister should cover your loss of income and support your family while you recover.
Your children are your responsibility, and they should not suffer (including financially) if you donate to your sister. The least she can do is to make sure you are not worse off from, basically, saving her life.

The main issue for me, though, is the risk of the surgery. There is a risk for you, and you can't guarantee that your children will be taken care of properly by your parents or your sister. If I was in a similar situation, I know that DS would be well cared for by one of my siblings, or my mum. But in your case, you don't even know if your sister wouldn't go back to drinking, even in charge of your children, should the worst happen.

She may never ask you because she understands that it is a huge thing to ask. And she may not be able to give you the reassurance you need.

So sorry for you and your sister, though.