Liver Transplant Surgery

Typically liver transplant patients spend about 8 hours in the operating room and the transplant surgery itself lasts 5-6 hours.

At California Pacific Medical Center, liver transplant patients are taken to the operating room where they are put to sleep. An experienced team of doctors, nurses, physician assistants and technicians performs the liver transplant. After inspecting the donor liver and marking important structures to be connected during surgery, the liver transplant surgeon makes an upside down Y-shaped incision in the abdomen to gain access to the abdominal cavity. Because the liver lies in part behind the rib cage, special retractors are used to hold open the abdominal cavity so the surgeons can more easily maneuver. The surgeon will use clamps to block blood flow from the major veins and arteries supplying the liver.

One's diseased liver is detached from the arteries and veins, and removed from the body. The new liver, which has been kept on ice and bathed in a nutrient solution, is placed in the same position as the original liver. The veins are connected first, followed by the hepatic artery and bile duct. After all of the connections are made, blood flow to the liver is resumed while the surgeons observe to ensure the new organ is working properly. After ensuring that the new liver is functioning well, the clamps and retractors are removed and the surgeon uses surgical staples to help the incision heal.

Intensive Care Unit

Liver transplant recipients will wake up from the operation in California Pacific's intensive care unit (ICU), a specialized unit with close monitoring. During the wake-up period, patients have a tube in their windpipe to help with breathing. It will be removed when the transplant recipient is fully awake and strong enough to breathe on his/her own. One may have other tubes as well. These tubes will be removed as recovery progresses. When it is safe for a patient to leave the ICU, the individual will be transferred to the hospital’s transplant unit.

Liver Transplant Unit

Here, the focus in care shifts to getting the liver transplant recipient walking and eating. Physical therapy also starts, as being active helps one recover. When patients begin to feel hungry and their bowels are working, they will be able to eat regular food that is low in salt. Blood tests are done every day and imaging studies will be ordered if needed. A liver biopsy may be done if there is any suspicion that the new liver is being rejected. Rejection is common and does not mean one is losing their liver. Medications are given to treat rejection, which are usually very effective.

Returning Home

Liver transplant recipients should anticipate spending 5 to 7 days in the hospital. Depending on one's condition, the stay may be shorter or longer. Before leaving the hospital patients will learn how to take their new medicines, how to recognize the signs of infection or rejection, how to change any wound dressings, and general health guidelines.

For patients who live more than 50 miles from California Pacific Medical Center, our team will require you to stay in or close to San Francisco for 30 days following your liver transplant. This enables you to easily get to the Medical Center should an emergency arise and puts you in close proximity for your required clinic visits and lab tests.

About California Pacific Medical Center

San Francisco Center for Liver Disease

California Pacific Medical Center, part of the Sutter HealthOpens new window network, offers specialized care in liver disease and liver transplant. Our program is based in San Francisco and has outreach locations throughout Northern California and Nevada.

California Pacific Medical Center
San Francisco Center for Liver Disease
2340 Clay Street, 4th Floor
San Francisco, CA 94115
Tel: 415-600-1020