Transplantation of the Liver

Imaging Techniques for Partial Grafting

Preoperative imaging plays a crucial role in optimizing outcomes and minimizing risks involved with partial liver grafting. The primary goals of imaging are to understand donor vascular and biliary anatomy, identify variant anatomy, assess hepatic segmental volumes, and exclude underlying…

Anesthesia for Liver Transplantation

Liver transplantation is a very successful and effective treatment for many different disorders of the liver. Improved techniques in surgery, anesthetic management, donor organ procurement, preservation, immunosuppression, and perioperative care have resulted in many centers reporting a 1-year survival rate…

Recipient Hepatectomy and Grafting

According to conventional clinical and surgical standards of the early 1960s, removal of a diseased liver and replacing it with a working, undamaged one was a concept that, although visionary and sound, had a low probability of being successfully executed.…

Principles of Liver Preservation

Liver preservation is one of the most important components of liver transplantation because the efficacy of preservation has an enormous impact on the posttransplant outcome. Especially in wide geographical regions with national organ sharing, liver preservation allows organs to travel…

The Donor Operation

The expeditious assessment and recovery of cadaver organs without surgical injury will always be the central mission of the donor surgeon; however, the current climate of organ scarcity has placed increasing demands upon the donor surgeon that require enhanced skill…

Donation After Cardiac Death

Donation after cardiac death (DCD), formerly referred to as non–heart-beating donation , has become the fastest-growing source of transplant organs in the United States over the past decade, bringing full circle the history of organ donation. This chapter reviews the…

Extended Criteria Donors

The disparity between supply and demand of organs for transplantation continues to grow, and the organ shortage has made it necessary to liberalize acceptance criteria to include donors beyond traditional criteria. These donors collectively are known as extended criteria donors…

Donor Selection and Management

It is estimated that each year in the United States approximately 20,000 potential brain-deceased donors are not properly identified as such; furthermore, of those unquestionably opting to donate lifesaving organs, 17% to 25% of donors are lost due to errors…

Portopulmonary Hypertension and Hepatopulmonary Syndrome

Pulmonary disease is common in patients with end-stage liver disease, and as many as 50% to 70% of patients with end-stage liver disease complain of shortness of breath. The differential diagnosis includes obstructive airway disease, infection, fluid retention with hydrothorax,…

Management of Portal Hypertensive Hemorrhage

Portal hypertension is most commonly a manifestation of underlying liver parenchymal disease and worsens with increasing severity of cirrhosis. It is responsible for complications, such as the development of varices and variceal hemorrhage, among chronic liver disease patients and often…