A liver transplant (hepatic transplantation) involves the replacement of a liver that is diseased with a liver that is healthy (allograft). The technique that is most commonly used is known as orthotopic transplantation. In this procedure, the original liver is removed and the donor liver is relocated in the same anatomic position as the original liver. While being one of the most expensive medical treatments, it is also an accepted treatment for acute liver failure and end-stage liver disease.
Prior to the decision for liver transplantation, liver support therapy may be indicated as an initial alternative. Bioartificial liver support options are currently under consideration while liver dialysis is in common practice, currently. Nearly all liver transplantation procedures are performed in an orthotopic fashion. The operation, itself, can be thought of as occurring in 3 stages; the hepatectomy stage (removal of the liver), the anhepatic stage (no liver) and the post-implantation phase. The hepatectomy procedure will involve a division of all ligament attachments to the liver along with the hepatic artery, common bile duct, portal vein and hepatic vein.
The blood in the donated liver is replaced with an organ storage solution that is ice-cold (such as HTK or Viaspan) until the organ is ready to be implanted. During the implantation, the hepatic artery, portal vein and the inferior vena cava are connected and the bile duct is constructed – either to the small intestine or the patient’s own bile duct, once blood flow to the new liver is established. The surgery will take between 5-6 hours but can extend further or be shorter, depending on the surgeon and the procedure difficulty.
The majority of liver transplantations involve the use of an entire liver from a non-living donor. While this may be the case for adult patients, there has been a major advance in pediatric transplants in which a portion of an adult liver can be used for two pediatric transplants for small children. Other developments in this area include a split liver transplant. This involves one liver that is used for two adult transplants. Another area of development involves using a portion of a healthy adult liver as an allograft. Living donor liver transplants involve using about 20% of a healthy adult liver for a small pediatric recipient.
Please note that this article is for informational purposes only and is not intended as legal advice.
A liver transplant can be an extremely debilitating event. For further information and claims assistance, telephone SSD/SSI Wichita Falls attorney Gerard Lynch, serving Houston and other Texas locations.
