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Liver Transplant Surgery

Transplantation of the liver has become more common within the last two decades.   This successful and effective surgery is a major, lifesaving operation typically done in the hands of an experienced liver transplant team.

After patients complete the evaluation and the team places them on the organ waiting list, they have the opportunity to meet with their surgeon to review the surgical procedure, including the risks and benefits of the operation and of transplant medications.   Patients remain in close contact with the nurse coordinator throughout the pre-transplant process. As the priority for liver transplant is based on the severity of illness, in some instances, patients may already be hospitalized . Once the surgery is set to begin, loved ones are directed to a waiting area where the hospital staff and operating-room team will continually keep them updated.   The large majority of liver transplants use the entire liver from a non-living donor for the transplant.   The organ is transported in cold storage from the location where it is removed from deceased donor.

Liver transplantation is an involved operation that typically takes at least five to 10 hours. The transplant surgeon makes an incision in the upper abdomen, and the surgical team detaches the diseased or injured liver from blood vessels and the common bile duct, clamps the vessels and duct, and removes the liver. The team then attaches the recipient’s blood vessels and common bile duct to those in the donor liver. The donor liver is typically placed in the same location where the diseased or injured liver was. The donor liver must be carefully attached to the patient’s circulatory and digestive systems. Tubes are sometimes placed around the transplanted liver to allow blood and fluids to drain out of the abdomen.  The surgical team may place a tube to temporarily drain bile from the new liver into an external pouch so the bile can be measured to determine whether the liver is producing bile as it should.  In cases where the recipient’s common bile duct cannot be connected to the donor’s bile duct, the donor bile duct is drained into a loop of small intestine.

After surgery, patients go to a surgical recovery room, where the Virtua Our Lady of Lourdes staff closely monitors them, and the surgeon meets with family members or support persons to further review the course of events and patient status.   The post-surgical stay is usually at least one week.   Patients are advised to not travel far from their transplant hospital during the initial months of recovery.   They begin a lifelong course of drugs that suppress the immune system to prevent the body from rejecting the organ.

Transplant coordinators at the Lourdes Regional Organ Transplantation Center work with the team hepatologists, transplant surgeons, nurses, social workers and other medical staff to assure a smooth transition to surgery and beyond, including advising on financial coverage, follow-up care and home-health services.   The center’s patients have the services of coordinators specifically designated as pre- or post-transplant coordinators.

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