Can You Live Without A Liver?

No, you cannot live without a liver. It filters about 1.5 liters (1.6 quarts) of blood a minute, produces bile, makes clotting factors, and synthesizes essential proteins. Total liver failure is fatal within days unless a transplant is performed. You can, however, survive with as little as 25% of a healthy liver, which regrows to full size within a few months.

Lose all liver function and the body has only days, not months. But there is something incredibly unique about the liver, and its nearly magical regenerative properties. That is why you can still walk away from surgery with only a quarter of your liver intact and end up perfectly fine.

If you ask someone if they are willing to live without an organ, they’ll probably respond with a definitive NO. What many people don’t realize is that you can actually live without a number of your organs. In some cases, this is because the body contains more than one, the function can be taken on by another part of the body, or procedures exist that can artificially handle the metabolic load.

For example, you can live without a kidney, a stomach, a gall bladder or an appendix. Some organs can also be partially removed without the outcome being fatal, such as the brain and intestines. However, what about your liver? What are your chances of surviving without that mysterious organ?

Liver: Can’t Live Without It

For those of you who don’t know what the liver is all about – or even where it is in the body – here’s a quick update. Weighing roughly 3 pounds on average, the liver is a 4-lobed organ. It is also the largest glandular organ in the body and has some rather incredible functions that help to keep us alive.

Where Is Your Liver Located?

The liver is located in the right side of the body in the upper quadrant of the abdomen. It is present beneath the diaphragm. Because of its size, it also enters into the left upper quadrant as well. The liver is protected by the lower ribs as it is a delicate organ.

What Does The Liver Do?

The liver does the heavy lifting when it comes to keeping our bodies toxin-free, processing roughly 1.5 liters (1.6 quarts) of blood every minute. With all of the potentially dangerous pathogens, drugs, and metabolic by-products circulating in the blood, without this critical function we wouldn’t last very long. Beyond that, the liver is also responsible for producing bile, which is crucial for breaking down fats during digestion. Without eliminating toxins and absorbing essential nutrients, we would be in very bad shape. As if that wasn’t enough, the liver also synthesizes most of the body’s clotting factors, which is what keeps a paper cut from turning into a serious bleed. Finally, the liver produces albumin and many other proteins that the body needs for proper metabolic activity. Clearly, the liver serves some rather important functions, and total liver failure is not a gradual decline; without a working liver or an emergency transplant, death follows within days.

Unfortunately, there are a number of reasons why a liver may need to be removed, which makes liver transplants and donations extremely important. The most notable causes of liver replacement or partial removal include benign liver masses, hepatocellular carcinoma (the most common form of primary liver cancer), metastatic malignancies of the liver (cancer cells that have migrated from other organs), and cirrhosis. Cirrhosis itself can be triggered by long-term alcohol use, chronic hepatitis B or C infection, or metabolic dysfunction-associated steatotic liver disease (MASLD, formerly known as non-alcoholic fatty liver disease), which has now overtaken viral hepatitis as the leading global cause of chronic liver disease. These afflictions, among a long list of others, can require a partial or complete removal of the liver.

Here is something counterintuitive: the liver is actually the most immunologically forgiving organ that doctors transplant. Chronic rejection rates for liver grafts run roughly 3–17%, compared with 20–40% for kidney and pancreas transplants and as high as 25–60% for heart transplants. The liver tissue is packed with regulatory immune cells that calm down the recipient’s defenses, and HLA matching matters far less for livers than it does for other organs. Even so, donors and recipients still need to be carefully evaluated. Given what we just explained about the essential nature of livers, the idea of living donors seems impossible, since that would mean sacrificing their own health. However, there are living donors for those who need a new liver, which is where the most impressive aspect of the liver comes into play.

Liver Regeneration: How Does The Liver Regrow?

While many organs have the power to heal themselves and even regenerate small portions, the liver has a remarkable ability to grow back, even when part of it has been removed. Therefore, when it comes to partial liver removals, the patient is often spared the challenge of finding a donor. The human liver can be cut down to 25% of its original size and still function properly for the human body.

Over time, the missing portion of the liver will regrow, eventually leaving the patient with a completely functional liver. The rate at which the liver grows back is astonishing; the fastest growth happens in the first one to two weeks following surgery (partial removal or partial donation), with the remnant typically reaching 75–90% of its original mass within two to three months. A slower phase of regrowth and functional maturation continues for a few months after that. Even during this phase of regeneration, the liver can continue to function as normal. While most doctors will tell you to lay off the alcohol so as not to put any undue stress on the liver, all the other essential functions of the liver will not be affected.

As mentioned above, that is why it is possible to be a living donor of your liver. If a person needs a complete liver transplant, a close relative can donate part of their liver, typically the left lobe (roughly 40% of total liver volume) or the right lobe (around 60%), depending on the size of the recipient. The donated piece is placed in the patient who needs the transplant, and provided there is no tissue rejection, both donor and recipient recover normally. Within a few months (about eight to twelve weeks in most cases), both halves regrow into fully functional, normal-sized livers. The oral mucosa lining your mouth heals faster than any other tissue in the body (thanks to growth-factor-rich saliva, not just blood supply), but among the major internal organs, the liver is in a league of its own when it comes to regrowing itself.

Therefore, if one of your close family members is ever in need of a complete liver transplant, don’t worry about them asking you to sacrifice yourself and hand over your healthy liver; you certainly can’t live without the organ, but you also don’t need a full liver to survive and enjoy a normal life!