The Transplant Surgery

Donor:

After the incision, the flaps are open to expose the liver. As the liver is situated below the ribs, clamps (also known as rib spreader) will be used to ‘lift’ and hold the ribs so the surgeon can see properly. As part of the surgery, the surgeon also removes the gallbladder since it is located under the part of the liver that will be removed. The liver is then split into 2 according to the lobes. The surgeons remove about 40 to 60 percent of the donor’s liver, depending if the recipient is paediatric or an adult.

• If the recipient is a child, a portion of the left lobe is taken.
• If the recipient is an adult, the right lobe is removed.

The veins, bile ducts, and arteries of the donated lobe are clamped and cut. The portion of liver meant for the recipient is removed, flushed with preservative solutions, and cooled on ice. The time between removing the portion of liver and transplanting it into the recipient is known as ischemic time. The liver graft is quickly transplanted into the recipient, keeping the time the liver graft is without circulating blood to a minimum. This also allows a higher chance that the liver graft will function well after transplantation. Drain tubes are inserted into the surgical area to drain fluid and bile during the surgery and are left in place for few days after the surgery. The incision is then closed with either self-absorbing sutures or staples which will be removed during follow-up visits. The entire donor operation takes six to eight hours to complete, from the first cut to the close of the incision.

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