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Preparation for liver transplantation
Last reviewed: 04.07.2025
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The patient is prepared for liver transplantation using standard methods. All details of the upcoming operation should be discussed with the patient and his relatives and their consent should be obtained.
Standard clinical, biochemical and serological studies are carried out, as accepted in patients with liver diseases.
They determine the blood group, HLA and DR antigens, anti-CMV and anti-НСV antibodies, as well as hepatitis B markers.
In patients with malignant tumors, all possible methods are used to exclude metastases.
The hepatic artery should be visualized to detect any anatomical abnormalities, including anomalous origin of the hepatic artery and preduodenal position of the portal vein. The portal and inferior vena cava should also be visualized. Selective angiography of the right renal artery is also performed, since a high position of the right kidney that is not recognized in time may lead to an inevitable right nephrectomy. The bile ducts are examined preoperatively by cholangiography, usually performed endoscopically. Standard ultrasound and computed tomography are performed. A thorough assessment of the heart and lungs should include measurement of pulmonary venous pressure.
Preoperative preparation for liver transplantation takes approximately 10 days. It includes confirmation of the diagnosis, consultation with a psychiatrist. The patient may wait many months for a suitable donor liver, and during this period intensive psychosocial support is necessary.
Vaccinations are carried out against HBV, pneumococci and influenza viruses.
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