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.
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.