Dr. Sanoop Kumar Sherin Sabu M.D., FCPM.,
During my undergraduate days and my post graduate MD Internal Medicine training, while learning about CLD or treating patients with DCLD, I often used to wonder how the liver grossly looks and have wondered what’s the whole lot of liver transplantation program. I am now fortunate to get my super specialty training in Medical Gastroenterology and Hepatology, with active involvement in Liver Transplantation program in pre transplant patient evaluation ,donor liver collection team, the long 10 + hours of liver transplantation surgery and post transplantation care, it made me more excited. So I thought, I will share few images to help the medicos out there, who haven’t seen a liver in person, few images of different appearance of liver to make them too understand.
The below images makes you understand how liver looks grossly while we do liver transplantation.
There are 3 grossly different appearing livers during the process of a Deceased Donor Liver Transplantation (DDLT).
1st- The deceased Donors normal appearing smooth surface, brown liver before the vascular pedicles are cut.
2ndly The Donor liver, when the vascular pedicles are cut and maintained in cold ischemia, as the cold ischemia time increases, the appearance starts to change.
3rd The Recipient’s Cirrhotic Liver with irregular, nodular appearing liver
The liver transplantation does not end just with a successful surgery. It is a team work of Transplant surgeon, Gastroenterologist and hepatologist, Intensivist, Radiologist and Infection control team along with a team of dedicated staff. Post transplant period is a crucial time where patient can have many immediate complications like acidosis, hypoglycemia, sepsis, bleeding, Hepatic Artery Thrombosis (HAT), rejection, immunocompromise.
Therefor consistent prayerful team work , selection of ideal recipient and donor is very mandatory for successful outcome.
About the Author
Passionate Physician, Trained as Medical Gastroenterologist & Hepatologist
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