What is the surgical procedure for transplanting a liver from a living donor?

Evaluating the liver through images. Before performing the actual surgery, many images – including 3D images – of the donor’s liver are analyzed. The surgeons determine the precise size of the donor’s liver, blood vessel anatomy, how much liver tissue will be transplanted, the exact section of liver tissue to be removed, and calculate how much liver tissue is needed to allow the transplant recipient to survive. At least 30 percent of the living donor’s liver must remain in the donor.

The possibility of using the liver donor’s left lobe is considered first since this is a safer operation for the donor. A smaller portion of the left lobe, called the left lateral segment, is used if the liver transplant recipient is a small child.

Sections of the liver used for liver transplant

Living donor liver surgery. The transplant procedure begins with an incision made down the abdomen to enter the abdominal cavity. The predetermined amount of the left or right lobe is removed from the donor. The gallbladder is also removed. The surgery takes about four to six hours to perform.

Recovery after surgery. The donor leaves the operating room with a drain in his or her abdominal cavity (to drain fluid and blood), IV lines in the arm and neck (to provide fluids and medications), a nasogastric tube (to relieve pressure in the stomach by removing contents and air), and a urinary catheter (to drain urine from the bladder). The donor’s first night is spent in the ICU, then he or she is transferred to the regular nursing floor if stable. The hospital stay is about 1 week. The donor is expected to leave the hospital without any tubes or drains, and return to visit the surgeon about 1 week after discharge. Follow-up checkups are required at 1 month, 3 months, 1 and 2 years after donation and more often if there are complications.

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