Waiting for a liver transplant and want to know what to expect? The following is a description of the transplant process, as well as overviews of other surgical methods that can be used for liver transplantation.

Adult Cadaveric Liver Transplantation
Adult cadaveric liver transplantation is the original transplant procedure, first performed in 1964. It is still the most common liver transplant procedure performed today. Adult cadaveric liver transplantation involves the removal of the entire recipient's liver and replacement with a whole organ obtained from a cadaveric donor.

Liver Transplant Surgery
Following the administration of anesthesia, patients are taken to the operating room where a team of about 10 physicians, nurses, physician assistants and technicians perform the liver transplant. After inspecting the donor liver and marking important structures to be connected during surgery, the liver transplant surgeon makes a Y-shaped incision in the abdomen to open the abdominal cavity.

Because the liver lies in part behind the rib cage, special retractors are used to help hold open the abdominal cavity so the surgeons can more easily maneuver. Next, the surgeon uses clamps to block blood flow from the major veins and arteries supplying your liver. The diseased liver is detached from the arteries and veins, and removed from your body.

The new liver, which has been on ice awaiting transplant, is placed in the same position as the diseased liver. The veins are first connected with sutures, followed by the hepatic artery and bile duct. After it is successfully sutured, blood flow to your liver is resumed while the surgeons observe to ensure the new organ is working properly. After ensuring that the new liver is functioning well, the clamps expanding the chest cavity are removed and the surgeon uses surgical staples to help the incision heal. The staples stay in place for about 2 - 3 weeks and are covered by a dressing, which will remain in place for a few days following surgery.

While each transplant is different, typically patients spend about 8 hours in the operating room. The surgery itself lasts 5-6 hours. Following surgery the ICU nurse wakes the patient to prepare him/her for coming off the ventilator. The breathing tube is also removed in about 6-12 hours.

Other Surgical Options
Our surgical capabilities enable us to provide advanced techniques that increase patients' chances for excellent outcomes. In addition to cadaveric liver transplantation, we  offer advanced adult living-donor liver transplantation, auxiliary liver transplantation and split-liver transplantation. These procedures provide patients with the chance to reduce waiting times and improve their quality of life.

Adult Living-Donor Liver Transplantation
Living-donor liver transplantation for adults is a new procedure that gives patients hopes of avoiding long waiting periods for a donor organ. Along with avoiding the long wait for a cadaveric donor liver, patients may also avert the serious consequences that often come with the long wait: progression of disease or even possibly death.

Living-donor liver transplantation for adults evolved from the successes experienced with living-donor transplantation in children and split-liver transplantation. Living-donor liver transplantation in children has been performed for more than ten years with excellent results and in some centers, frequently accounts for as much as one-half of all liver transplant procedures performed upon children.

Advantages of Living-Donor Transplantation
The principal advantage of living-donor liver transplantation is the ability to optimize the timing of transplantation, thereby avoiding long waiting periods and progression of liver disease. As in split-liver transplants, this technique is possible because the livers of both donor and recipient will grow and remodel to form a complete liver in the post-transplant period.

Who Can Be a Liver Living Donor?
Rigorous donor selection criteria is used to select only individuals having a very high probability of complete recovery from the procedure while providing a piece of liver that will immediately function. Our primary concern throughout this process is the safety of the donor. If our transplant physicians decide that there would be too great a risk to the donor, they will not go forward with the procedure.

In order to donate, a person must be in good health, be of a compatible blood type to the recipient and be motivated to donate from altruistic basis. We believe outcomes for adult donors will be positive, based on the positive outcomes experienced by pediatric liver transplant donors, which have been performed for over 10 years. Risks to the donor include but are not limited to bleeding, infection, bile leakage, and possibly death. For further information, email us.

Adult Split-Liver Transplantation
Adult split-liver transplantation is a technique in which a whole cadaveric donor liver is "split" into two approximately equal halves, each of which is transplanted into a different adult. Thus, one adult cadaver can donate to two recipients. This technique is possible because of the liver's unique ability to regenerate after transplantation. Following transplantation, each liver half will grow and remodel to form a complete liver. Split-liver transplantation has been performed for more than ten years with excellent results. Presently, split-liver transplantation is reserved for optimum cadaveric grafts to maximize their regenerative potential.

Adult Auxiliary Liver Transplantation
Adult auxiliary liver transplantation is a specialized technique whereby a small section of liver is removed from the recipient and replaced with a small piece of liver from a cadaveric or living-donor to "temporarily" assist a recipient's native liver.

This technique is indicated in situations where short-term augmentation of liver function is necessary such as in exposure to drugs or toxins. In these situations, the donated piece of liver provides enough function for the recipient's native liver to recover. After recovery, the donated section of liver is removed allowing the recipient to discontinue all medications and live with only their native liver.