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Once a donated liver has been inspected by the surgeon
and the candidate deemed ready for the operation and
prepped, the miracle of liver transplantation is about
to enter its prime hour. Family members can wait at
home or on the E-Level of University Hospital’s Surgical
Intensive Care Unit (SICU). Either way, a nurse coordinator
will regularly update them on the patient’s progress.
Liver transplant surgery is extremely complex and may
last 6-12 hours, depending on the patient’s condition.
The diseased liver is removed, and the major blood vessels
that feed and drain the liver are left in place. The
donor liver will be attached to these blood vessels
and the bile duct. A small incision called a venous
cutdown may have to be made in the groin area during
the surgery. A tube may need to be inserted into a large
vein in the groin to help blood from the lower part
of the patient’s body to be circulated during the time
that the liver is being removed and the donor liver
is being sewn in.
The Surgical Intensive Care
Unit
Following surgery, adult liver transplant patients
are taken to the SICU for recovery. This unit has the
equipment and specially trained nursing staff for quick
response if a problem occurs. Patients remain in the
SICU until their condition is assessed by a physician
as stable, usually several days.
While in the SICU:
• Patients may have family visitors. Gifts such
as flowers, plants, or fruit baskets are not permitted
in the unit. This policy is necessary to prevent infection.
• Several tubes and catheters will be attached
to the patient to assume and monitor certain functions.
For example, a tube placed down the throat attached
to a ventilation monitor for breathing; I.V. catheters
to provide information about heart and lung functions
and monitor blood pressure; tubes for drainage along
the incision site; a catheter to relieve the bladder
of urine; and a suction machine attached to a tube placed
in the nose, leading to the stomach, to keep the stomach
empty.
• Patients will be asked to cough and breathe deeply
using a special device called an "incentive spirometer"
to expand the lungs once able to breathe voluntarily
without the aid of the ventilator.
After the SICU
As soon as patients are medically stable, they are
transferred from the SICU to the transplant surgery
unit, which is located on the E-Yellow floor of University
Hospital. They are cared for by specially trained liver
transplant nurses, the transplant surgeons, and transplant
hepatologists until their discharge. The length of hospital
stay following transfer from the SICU varies depending
on an individual’s condition but averages about two
weeks.
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The
Transplant Process
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