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Liver Transplant Procedure

Admission Process

When a liver becomes available, the patient will be notified and be urgently admitted to the hospital. Upon admission, the patient will meet again with a transplant hepatologist and a transplant surgeon to answer any questions, and a consent form will be signed to authorize the procedure.

Transplant Procedure

Liver transplantation is a major operation that requires a specialized team of surgeons, anesthesiologists, and operating room staff. The liver transplant procedure usually takes 4-6 hours to perform, but operating time may be longer in patients with prior abdominal surgery. Liver transplantation is performed under general anesthesia, and our specialized transplant anesthesiologists ensure that our patients receive the best available care during their operation.

Opening

Once under general anesthesia, the procedure begins with the surgeon making a curved horizontal incision in the abdomen, just under the ribs. Most liver transplants can be performed through this incision, which heals significantly better than the "Y" shaped incision used in most other centers.

Removal of the Diseased Liver

The first step in the operation is to remove the diseased liver in its entirety. The liver is freed from its attachments until it is held in place by only the major blood vessels. These vessels are then clamped and divided and the liver is removed.

Implantation of New Liver

Once the diseased liver is removed, the second step is to implant the new liver. The new liver is placed in the same location previously occupied by the diseased liver. The blood vessels of the new liver are connected to the corresponding blood vessels in the recipient to allow blood to flow in and out of the liver. Finally, the bile duct of the new liver is connected to the recipient's bile duct to allow normal bile flow.

After the transplant operation patients are taken directly to the dedicated Transplant Surgery Intensive Care Unit (TSICU) to recover from surgery. All patients will have a urine catheter and a special IV for administering medications. These are usually removed in the first two days after transplant. Several abdominal drains will be in place for several days, as well as a small drain in the bile duct.

Hospital Stay and Discharge

Most patients are in stable condition and are awake the same day as their liver transplant. The majority of patients are transferred out of the TSICU to the regular transplant surgery floor within two days of their transplant. Eating, drinking, and walking are strongly encouraged as soon as possible after transplant. Most patients are discharged from the hospital within a week of their transplant surgery.