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Liver transplant - series

Normal anatomy

The liver is in the right upper abdomen. The liver serves many functions, including the detoxification of substances delivered to it from the intestines, and the synthesis of many proteins.

Indications

A liver transplant may be recommended for:

• Liver damage due to alcoholism (Alcoholic cirrhosis)
• Primary biliary cirrhosis
• Long-term (chronic) active infection (hepatitis)
• Liver (hepatic) vein clot (thrombosis)
• Birth defects of the liver or bile ducts (biliary atresia)
• Metabolic disorders associated with liver failure (for example, Wilson disease)

Incision

Liver failure causes many problems, including malnutrition, problems with blood clotting, bleeding from the gastrointestinal tract, and jaundice. Frequently, patients who undergo liver transplantation are quite ill, and require hospitalization in the Intensive Care Unit prior to surgery. A large, upper abdominal transverse incision is used for liver transplant.

Procedure

Liver transplants are performed in many centers across the country. The healthy liver is obtained from a donor who has recently died but has not suffered liver injury. The healthy liver is transported in a cooled saline solution that preserves the organ for up to 8 hours, thus permitting the necessary analysis to determine blood and tissue donor-recipient matching. The diseased liver is removed through an incision made in the upper abdomen. The new liver is put in place and attached to the patient's blood vessels and bile ducts. The operation can take up to 12 hours to complete and requires large volumes of blood transfusions.

Aftercare

Patients require hospital care for one to four weeks after liver transplant, depending on the degree of illness. After liver transplantation, patients must take immunosuppressive medications for the rest of their lives to prevent immune rejection of the transplanted organ.

Review Date: 5/4/2022  

Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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