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We examined short\u2010 and intermediate\u2010term outcomes associated with living liver donation using the Scientific Registry of Transplant Recipients. This retrospective cohort study included 8619 donors aged 18\u201365\u2009years who donated between 1989 and 2023, of whom 8314 had follow\u2010up data for secondary outcomes. Donors were categorized by era: early (1989\u20132006) and contemporary (2007\u20132023). Primary outcomes were 90\u2010day and 2\u2010year mortality; secondary outcomes were changes in physical capacity, functional status, and employment. Mean donor age was 36\u2009years, and 53% were female. Eight donors (0.1%) died within 90\u2009days and 18 (0.2%) within 2\u2009years. Mortality was lower in the contemporary era at both 90\u2009days (HR: 0.14, 95% CI: 0.03\u20130.70) and 2\u2009years (HR: 0.06, 95% CI: 0.02\u20130.18). Reduced physical capacity at 6\u2009months was more common among contemporary\u2010era donors (aOR: 3.25, 95% CI: 1.32\u20138.00) and Hispanic donors (aOR: 2.07, 95% CI: 1.29\u20133.32). Reduced employment was more common among non\u2010White donors at 6\u2009months and 1\u2009year (aOR: 2.04, 95% CI: 1.40\u20132.97 at 1\u2009year), and among female donors at all timepoints (aOR: 1.71, 95% CI: 1.29\u20132.25 at 1\u2009year). Living liver donor mortality has declined over the past three decades, and long\u2010term physical impairments are uncommon. Reduced employment following donation is disproportionately reported by female and non\u2010White donors. These findings provide a benchmark for center\u2010level assessment of donor outcomes and may inform donor counseling that addresses occupational circumstances alongside surgical risk.<\/jats:p>","DOI":"10.1155\/joot\/2545887","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:37:57Z","timestamp":1791182277000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Three Decades of Living Liver Donor Outcomes: A National Cohort Analysis of Patterns in Mortality and Recovery"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8969-425X","authenticated-orcid":false,"given":"Morgan E.","family":"Kelly","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of California San Francisco  San Francisco California USA  ucsf.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2762-1630","authenticated-orcid":false,"given":"Tianna M.","family":"Truby","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California San Francisco  San Francisco California USA  ucsf.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2092-6380","authenticated-orcid":false,"given":"Jennifer C.","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA  ucsf.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5565-6670","authenticated-orcid":false,"given":"Sharad I.","family":"Wadhwani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California San Francisco  San Francisco California USA  ucsf.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"e_1_2_12_1_2","article-title":"Liver Transplantation","author":"Lucey M. 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