*
Normal vs. Diseased Liver  
nucleus factsheet image

Copyright © Nucleus Medical Media, Inc.

Definition  

This is a surgery to replace a diseased or damaged liver with a liver from a donor who has died. In some cases, a portion of the liver of a living, related donor may be used.

*

Reasons for Procedure  

A liver transplant is done to treat a liver that is not working and cannot be treated. This may be caused by:

  • Cirrhosis
  • Hepatitis A , B , or C
  • Alcoholic liver disease
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis, which is a disease of the bile ducts
  • Sudden liver failure
  • Congenital defects such as biliary atresia
  • Liver tumors
  • Metabolic defects such as Wilson disease
  • Poisoning or drug-induced damage
*

Possible Complications  

If you are planning to have liver transplant, your doctor will review a list of possible complications, which may include:

  • Rejection of the transplanted liver
  • Bleeding
  • Infection
  • Damage to nearby organs
  • Bile-duct obstruction or bile leakage into the body
  • Complications from immunosuppressive drugs
  • Blood clots

Some factors that may increase the risk of complications include:

Be sure to discuss these risks with your doctor before the surgery.

*

What to Expect  

Prior to Procedure  

There is a shortage of donors. You may be on a transplant list for some time. You may need to carry a cell phone with you at all times. This is to allow the transplant team to reach you if a liver becomes available.

Your doctor will likely do the following:

  • Physical exam
  • Blood tests
  • Ultrasound
  • CT scan
  • Chest x-ray
  • Electrocardiogram (EKG)
  • Psychological testing and counseling—to help you to be prepared for the transplant

Leading up to your surgery:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
  • Take medications as directed. Do not take over-the-counter medications without checking with your doctor.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.
  • Arrange for someone to drive you home. Also, arrange for someone to help you at home.
  • If advised by your doctor, use an enema. The enema will clean out the intestines and prevent constipation after surgery.

Anesthesia  

General anesthesia will be used. It will block any pain and keep you asleep through the surgery.

Description of the Procedure  

An incision shaped like a boomerang will be made on the upper part of the abdomen. The old liver will be removed. Portions of major blood vessels will be left in place. The new liver will be inserted and attached to the blood vessels and bile ducts. To help with bile drainage, a tube will also be inserted into the bile duct during surgery. The area will be closed with stitches.

Immediately After Procedure  

You will be closely monitored in the intensive care unit (ICU) and will have the following devices:

  • Breathing tube until you can breathe on your own
  • IV fluids and medication
  • Bladder catheter to drain urine

How Long Will It Take?  

Several hours

How Much Will It Hurt?  

Anesthesia will prevent pain during the surgery. You will have pain while recovering. Your doctor will give you pain medication.

Average Hospital Stay  

This surgery is done in a hospital setting. The usual length of stay is several weeks. Your doctor may choose to keep you longer if you show signs of rejecting the new liver or have other problems.