The liver is one of the largest and most complex organs in the body. It weighs about one pound in adults and is made up of a spongy mass of wedge-shaped lobes. The liver has numerous functions that are necessary for life. The liver helps process carbohydrates, fats and proteins, and stores vitamins. It processes nutrients absorbed from food in the intestines and turns them into materials that the body needs for life. For example, it makes the factors that the blood needs for clotting. It also secretes bile to help digest fats, and breaks down toxic substances in the blood such as drugs and alcohol. The liver is also responsible for the metabolism of most drugs.
U.S. Liver Transplants Performed
The chart below shows the number of liver transplants performed each year from January 1, 2003 - May 31, 2009. Based on current OPTN data as reported on August 21, 2009. Data subject to change based on future data submission or correction.
The process of being admitted and preparing for transplant surgery can vary greatly. Talk to your physician about how your transplant hospital will handle this phase of the process.
The Procedure
There are two very different surgical approaches to liver transplantation: the orthotopic and the heterotopic approach, both of which can take up to ten hours to complete. Because the length of this surgery is different for every patient, families should talk with the surgeon about what to expect.
Orthotopic Approach. The orthotopic approach requires replacing the recipient liver with the donor liver. After the donor liver is removed, preserved and packed for transport, it must be transplanted into the recipient within 12 to 18 hours. The surgery begins by removing the diseased liver from the four main blood vessels and other structures that hold it in place in the abdomen. After the recipient's liver is removed, the new healthy donor liver is then connected and blood flow is restored. The final connection is made to the bile duct, a small tube that carries bile made in the liver to the intestines.
Heterotopic Approach. In heterotopic liver transplantation, the recipient's liver is left in place and a donor liver is sewn into an ectopic site. Your physician can explain why this approach may better suit your needs.
During Recovery
Postoperative care begins with a team of heath professionals within the hospital. Careful, comprehensive post-surgical monitoring constantly evaluates whether the body is accepting the new organ. In addition, the amount of time you spend in the recovery room, waking up and getting to the point that you're ready to go home, will vary from patient to patient. Because individual experience after recovery is so unique, it is important to discuss with your physician what to expect after surgery.
