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- When a donor organ becomes available.
One of our five liver surgeons, reviews the information
about the donor and decides if we think
that it is a suitable liver for you.
Who performs your liver transplant
is based on a rotation or call schedule.
You will meet your liver surgeon on the day
of your operation.
If the donor is a good match for you on paper,
the team will call you and ask that you come to the hospital
in Detroit to prepare for transplant.
While you are making your way to us,
a team will go to evaluate the liver in person
and perform the operation on the donor to get the liver.
One of the important things for success in liver transplant
is that the liver is outside the body
for the shortest period of time.
So, it is very important that we are ready
to start your operation, as soon as the team confirms
that the liver is usable.
However, there's always a chance
that when the team evaluates the liver,
they will not think that it is suitable for transplant.
These false starts can be disappointing,
but they are necessary in order to ensure
that you are ready to go when the organ is usable.
If everything looks okay with the donor liver,
and you are an acceptable condition for liver transplant,
then we make the decision to go ahead with the operation.
The liver transplant operation takes
about six to eight hours,
after putting you to sleep and placing special IVs
to monitor and care for you during the operation.
The first part of the operation is to remove
the entire liver and the gallbladder,
even in situations where you may be receiving
a part of a donor liver, your entire liver will be removed.
The second part of the operation is putting
in the new liver.
When we put in the new liver,
we make four connections between your body
and the new liver.
The four connections we make to the new liver,
reflect the liver functions.
Three of the new connections labeled here,
as one, two, and three, bring blood into the liver
and out of the liver.
And back to your heart.
The fourth connection connects the liver to the intestine.
This allows for digestive fluid called bile
that is made in the liver to flow into the intestine.
We generally use two types of incisions for surgery,
which incision is used is based on the shape of your belly
and ensures that we have enough space
to perform the operation.
Surgical drains will be placed at the time of your surgery.
These drains collect fluid from the belly
and help us to assess how things are healing on the inside,
based on the color and the amount of fluid.
Generally, these can be removed in your hospital room,
prior to leaving the hospital.
After the transplant operation,
you will be taken directly to the intensive care unit.
In about half of our patients,
the breathing tube placed at the beginning of surgery,
will be removed immediately at the end.
And patients where the breathing tube needs
to remain in,
it is usually able to be removed within the first 12
to 24 hours after surgery.
If the breathing tube remains in,
you'll be given medications to keep you comfortable
while it is in place.
The ICU stay, is typically about one to three days.
When you are stable to leave the intensive care unit,
you will be transferred to the transplant unit
in the hospital.
All of our patients recover in the same unit
and we have an amazing team of nurses
and other care providers with experience taking care
of post-transplant patients,
that will assist you with your recovery.
The average length of stay in the hospital is nine days.
When you are medically ready to leave the hospital,
you either go straight to home or to a rehab facility.
The physical therapy team will help assess
where is best for you to go.
When you go home,
you will need a support person
to help you while you recover.
We ask that you do not stay alone for about a month.
This is not because you will need to be waited
on hand and foot, but you may need assistance with mobility,
medications, mood, and transportation.
We recommend that you have several people
who can support you in this role.
If, when you're otherwise medically ready
to leave the hospital,
you are not quite ready to go home from a strength
and stamina standpoint.
Then you may go to a rehab facility for a period
of time before you transitioned to home.
After leaving the hospital,
you will be seen frequently in our clinic
and have your blood drawn to assess the recovery
of your liver.
And to make sure that you have the right amount
of anti-rejection medication in your body.
These visits are initially one to two times a week,
and are transitioned to less frequent
as your recovery stabilizes.