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Liver transplant - How it is performed

NHS Choices Medical Reference

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You will be contacted by staff at the liver transplant centre as soon as a suitable liver becomes available. It will need to be the right size and match your blood group.

The call could be at any time during the day or night, so you may be given a bleeper to alert you. If necessary, you may be given transport to the transplant centre.

It is important not to eat or drink anything from the time the transplant centre contacts you.

Once you arrive at the transplant centre, you will be given a chest X-ray and an electrocardiogram (ECG) so that your heart and lung function can be reassessed. You will then be given a general anaesthetic in preparation for the transplant.

Orthotopic transplant

The most common type of liver transplant is an orthotopic transplant, where a whole liver is taken from a recently deceased donor.

The surgeon will make a cut in your abdomen and remove your liver. The donor liver will then be put in position and connected to your blood vessels and bile ducts (small tubes that move bile out of the liver).

After the donor liver is in place, the incision will be sealed using dissolvable stitches. Drainage tubes will be attached to drain away extra fluids, and they will usually remain attached for several days after surgery.

Once the transplant has been completed, you will be moved to an intensive care unit (ICU) to recover.

Living donor transplant

During a living donor transplant, the donor will have an operation to remove either the left or right side (lobe) of their liver.

Right lobe transplants are usually recommended for adults. For children, left lobe transplants are recommended. This is because the right lobe is bigger and better suited for adults, while the left lobe is smaller and better suited for children.

After the donor operation, your liver will be removed and replaced with the donor's liver lobe. Your blood vessels and bile ducts will then be connected to the liver lobe.

Following transplantation, the transplanted lobe will quickly regenerate itself. In most cases of living donor transplants, the new lobe will grow to 85% of the original liver size within a week. 

Split donation

A split donation may be carried out if a donor liver becomes available from a recently deceased person, and you and a child are both suitable candidates for a donation.

The donated liver will be split into the left and right lobes. Normally, you will be given the larger right lobe and the child will receive the smaller left lobe.

A number of liver transplant units have performed successful split donation transplants in two adults, although the adult receiving the smaller left lobe usually has to be much smaller than average for the transplant to be successful.

Medical Review: January 22, 2013
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