47140 Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III)

Name of the Procedure:

Donor Hepatectomy (including cold preservation), from Living Donor; Left Lateral Segment Only (Segments II and III)

Summary

Donor Hepatectomy involves the surgical removal of the left lateral segment of the liver (segments II and III) from a living donor. This portion of the liver is then preserved in a cold solution until it is transplanted into a recipient.

Purpose

This procedure is primarily performed to provide a liver segment for transplantation to a patient with end-stage liver disease or acute liver failure. The transplant aims to replace the recipient's failing liver with a healthy segment, improving liver function and saving the recipient's life.

Indications

• Severe liver disease unresponsive to other treatments
• Acute liver failure
• Certain genetic or metabolic liver diseases
• Patient must have a compatible living donor who is in good health and fits the criteria for donation

Preparation

• The donor must undergo comprehensive medical and psychological evaluations to ensure they are suitable for donation.
• Preoperative tests include blood tests, imaging studies (like CT or MRI), and possibly a liver biopsy.
• Donors may be required to fast for a specific period before the surgery.
• Medication adjustments may be necessary.

Procedure Description

1. Anesthesia: The donor is placed under general anesthesia.
2. Incision: A surgical incision is made in the abdomen to access the liver.
3. Isolation: The left lateral segment of the liver (segments II and III) is carefully isolated.
4. Excision: The isolated liver segment is surgically removed with precision.
5. Cold Preservation: The removed liver segment is immediately placed in a cold preservation solution to maintain its viability until transplantation.

Duration

The procedure typically takes 4 to 8 hours.

Setting

This surgery is performed in a hospital operating room equipped for complex transplant surgeries.

Personnel

• Transplant Surgeon
• Anesthesiologist
• Surgical Nurses
• Operating Room Technicians
• Hepatologist (Liver Specialist)

Risks and Complications

• Bleeding
• Infection
• Blood clots
• Bile leakage
• Pain and discomfort at the incision site
• Liver dysfunction in the donor
• Risks associated with anesthesia

Benefits

• Provides a potentially life-saving transplant for the recipient.
• The donor's liver usually regenerates to near its original size within a few months.
• Donors often experience personal satisfaction from helping a loved one.

Recovery

• Donors typically stay in the hospital for about 5 to 7 days post-surgery.
• Full recovery can take up to 6 weeks or longer.
• Instructions include managing pain, avoiding heavy lifting, and following up with healthcare providers.
• Regular follow-up appointments are necessary to monitor the donor's recovery.

Alternatives

• Deceased donor liver transplantation: More commonly available but can have longer wait times.
• Medical management: Managing symptoms without surgery, though often less effective for severe liver disease.
• Emerging therapies: Experimental treatments or clinical trials, which may not be widely available or proven.

Patient Experience

During the procedure, the donor will be under general anesthesia and will not feel pain. Post-surgery, they may experience pain, fatigue, and discomfort, which can be managed with medication. The surgical team and nursing staff will focus on ensuring the donor's comfort and pain management throughout recovery.