Transplantation

The Surgery

When you are called to come to the hospital for a transplant, the coordinator will let you know when to stop eating and drinking. You will be wheeled to the pre- operative holding area where a member of the anesthesia team will meet you to review your medical history, allergies, and order the necessary medications to prepare you for your surgery. Patients who have liver disease often have trouble with the clotting of their blood. As such, you may require blood transfusions throughout the surgery.

Once you are taken into the operating room, the doctors will begin placing monitors on you to watch your heart and lung function before, during, and after surgery.

In preparation for surgery, the team will start a few intravenous lines where the anesthesia team will give you medications, and monitor how you are tolerating the surgery. The anesthesia team will put you to sleep prior to the surgery by administering anesthesia medications.

Once you have gone to sleep, an airway tube is placed to assist your breathing throughout the procedure.

Some patients will have this tube in place for a short time after surgery. Once the breathing tube is removed, you might notice a sore throat, this is normal, there is no need for concern. If the breathing tube cannot be removed, you will be placed on a ventilator that will breath for you.

Liver transplant surgery is extremely complex and may last from 6-12 hours. Your entire liver and gall bladder will be removed and replaced by the donor liver. To do this, the surgeon must make a large incision in your abdomen. Your liver is removed and the major blood vessels that feed and drain the liver will be left in place. The donor liver will be attached to these blood vessels and your bile duct. A small incision called a venous cut-down may have to be made in your groin area during the surgery. A tube may need to be inserted into a large vein in your groin to help the blood from the lower part of your body to be circulated during the time that your liver is being removed and the donor liver is being sewn in place. You may need to receive several units of blood and plasma during the operation.