The goals of California Pacific Medical Center's Liver Transplant Program are to prolong life and improve the quality of life for patients with liver disease who have no alternative medical or surgical therapies.

Annually, we perform more than 50 liver transplants and evaluate more than 1,000 patients from throughout Northern California and Nevada. Our experience shows that hepatitis C is the most common indication for transplantation, the current median waiting time is 363 days and the average hospitalization stay at California Pacific Medical Center is 8 days. Most importantly, our one-year patient survival rate from 1995 to 2000 is 92% and graft survival is 91%. Click here for more statistics.

Patients who are referred to California Pacific for liver transplantation undergo a two- to three-day evaluation in San Francisco in which they are seen by a transplant hepatologist, transplant surgeon, transplant nurse coordinator, psychiatrist, social worker, nutritionist/dietitian, financial counselor and other consultants. Additionally, extensive testing is performed to evaluate liver and kidney function.

An overview of indications for liver transplantation and the patient evaluation process is explained in our liver transplant information sheet.

Adult Deceased Donor Liver Transplantation

Adult deceased donor liver transplantation is the original transplant procedure, first performed in 1964. It is still the most common liver transplant procedure performed today. Adult deceased donor liver transplantation involves the removal of the entire recipient's liver and replacement with a whole organ obtained from a deceased donor.

Liver Transplant Surgery

Following the administration of anesthesia, patients are taken to the operating room where a team of about 10 physicians, nurses, physician assistants and technicians perform the liver transplant. After inspecting the donor liver and marking important structures to be connected during surgery, the liver transplant surgeon makes a Y-shaped incision in the abdomen to open the abdominal cavity.

Because the liver lies in part behind the rib cage, special retractors are used to help hold open the abdominal cavity so the surgeons can more easily maneuver. Next, the surgeon uses clamps to block blood flow from the major veins and arteries supplying your liver. The diseased liver is detached from the arteries and veins, and removed from your body.

The new liver, which has been on ice awaiting transplant, is placed in the same position as the diseased liver. The veins are first connected with sutures, followed by the hepatic artery and bile duct. After it is successfully sutured, blood flow to your 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 expanding the chest cavity are removed and the surgeon uses surgical staples to help the incision heal. The staples stay in place for about 2 - 3 weeks and are covered by a dressing, which will remain in place for a few days following surgery.

While each transplant is different, typically patients spend about 8 hours in the operating room. The surgery itself lasts 5-6 hours. Following surgery the ICU nurse wakes the patient to prepare him/her for coming off the ventilator. The breathing tube is also removed in about 6-12 hours.

To learn about recovery from liver transplant surgery, read Living With Your New Liver, our manual for post-transplant patients.