Orthotopic Liver Transplantation

Abstract

Since its introduction into clinical practice in 1963 by Starzl et al., the technique of orthotopic liver transplantation has been refined progressively. The original technique included resection of the recipient inferior vena cava (IVC) and the use of extracorporeal venovenous bypass. More confidence with the technique and the more frequent use of technical variants in pediatric liver transplantation have led to the development of recipient cava-preserving hepatectomy techniques without use of venovenous bypass and with or without use of a temporary portocaval shunt, independently of anatomical and general status of the recipient. Regardless of the exact technique, orthotopic liver transplantation is characterized by three stages: the pre-anhepatic, the anhepatic and the post-anhepatic stage. The technique of orthotopic liver transplantation, either with or without preservation of the recipient IVC, will be described following these three stages.