Liver transplantation

Abstract

Introduction: Liver transplant surgery is very difficult and hard to make. This surgical method allows to treat patients suffering from liver disease in advanced stages. Many scientists with continued history of liver transplantation, several surgical approaches have been proposed that liver transplantation be performed successfully and the patient's lifetime to be as high posttransplant. Developing research in immunosuppression has made disappear liver graft rejection thus increasing the life span of patients posttransplant. Purpos end Objectives: Study of surgical techniques used in liver transplantation. Efficacy posttransplant. Study anatomical variants and biliary vessels main maintaining quality graft, surgical techniques to container, donor, back-table, graft implantation. Materials and Methods: Gathering all the information related to the surgical and postoperative treatment. Research and publications carried out by Scientists in the field of liver transplantation. Results: Total hepatectomy technique "piggyback". Hilar dissection should be performed as high as possible (especially blood and bile). Cystic duct is ligated and sectioned. High hilar dissection (High Hilarious Dissection, HHD). Using high hilar dissection enables us to perform venous anastomosis sector. Dissection of the bile duct. Donor operation: Skin incision. Full mobilization of the right hepatic lobe. Issuance of right hepatic lobe of the inferior vena cava. Preservation for future reinpantarea vein diameter > 5mm. Hepato - caval ligament transection . Cholecystectomy with cholangiography subsequent cystic duct catheterization. Intraoperative ultrasound. Selective clamping the artery and portal vein straight boundary demarcation of hemificatul hemificatului left. Parenchymal transection with electrocautery. Pedicolului final clipping and bile ducts in the portal as hemificatului law. Technical Back -Table: weighing graft harvested. Wisconsin perfusion solution. Grading scale blood , bile and venous existing anatomical variants. Right hepatic artery is cannulated and dilated. Reanastomozate the manner termino-tenninal venous system with diameter greater than 5 mm. Mason venous anastomosis a 3- 5mm. Inplantation graft technique: end-to-end portal anastomosis. Reperfusion of a PVC 5 -9mm Hg, assess graft quality, complete hemostasis and bilistaza. Making Doppler ultrasound. Portosystemic shunts, splenic artery ligation, splenectomy. End-to-end anastomosis of the right hepatic artery. Bile duct reconstruction and prosthesis on stend transcoledocian externalized. Harvesting hemostasis and assessment of liver surface. One important thing ese posttransplant administration of immunosuppressants for graft rejection does not occur. Conclusion: Knowledge anatomical variants of the arteries, veins and biliary enables us to intervene surgically prepared as well as possible and post surgical complicatiilr less. Knowledge of surgical techniques allow us to perform surgery and how quickly how much less damage to both the donor as well as recipient. And immunosuppressive therapy increases the life of the patient.