Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and comm
CPT4 code
Name of the Procedure
Backbench Standard Preparation of Cadaver Donor Whole Liver Graft Prior to Allotransplantation (Including Cholecystectomy if Necessary)
Summary
This procedure involves preparing a liver from a deceased donor for transplantation into a recipient. The preparation includes removing the gallbladder (cholecystectomy) if necessary and dissecting the surrounding soft tissues to expose and prepare the major blood vessels.
Purpose
This procedure is done to ensure the liver graft is in optimal condition for transplantation. It aims to prepare the liver by cleaning and clearing the blood vessels, ensuring the liver can be successfully connected to the recipient's circulatory system.
Indications
- End-stage liver disease or liver failure in the recipient
- Liver tumors or cancer
- Hepatitis or other severe liver conditions
- Patient on the liver transplant waiting list
Preparation
- The recipient may need to fast for a certain period before the transplant.
- Blood tests, imaging studies, and other assessments to ensure compatibility.
- The donor liver is preserved and transported under sterile conditions.
Procedure Description
- The donor liver is placed on a sterile backbench.
- The gallbladder is removed (cholecystectomy) if present.
- Soft tissues surrounding the liver are dissected.
- Major blood vessels (vena cava, portal vein, hepatic artery) are carefully prepared and cleaned.
- Tools include surgical scalpels, scissors, forceps, and clamps.
- Performed under sterile conditions by surgical teams.
Duration
The preparation typically takes 2 to 4 hours.
Setting
Performed in a hospital setting, usually in a sterile surgical suite.
Personnel
- Transplant surgeon(s)
- Surgical assistants
- Operating room nurses
- Anesthesiologist (if required)
Risks and Complications
- Damage to blood vessels
- Incomplete removal of tissues
- Graft viability issues
- Infection
Benefits
- Optimizes success rate of liver transplant
- Ensures a better match and integration with the recipient’s body
- Improves overall outcomes and survival rates post-transplant
Recovery
- Not applicable directly to the patient as it's a donor preparatory procedure.
- Post-transplant, the recipient will follow a separate recovery protocol involving ICU stay, medications, and follow-ups.
Alternatives
- Living donor liver transplantation
- Medical management of liver disease for non-transplant candidates
- Artificial liver support systems (limited availability and effectiveness)
Patient Experience
- Procedure is done on the donor liver, not directly experienced by the patient.
- The recipient will undergo a separate surgical process for the transplant, involving anesthesia, pain management, and recovery protocols.