Implantation of the Deceased Donor Liver Graft

A longer ischemic time of more than 6 h has an obvious negative effect on the outcome of brain death liver transplantation. Liver graft procured at a geographically longer distance needs more time to recover graft function in general. Most centers prefer the piggyback technique for convenience. However, in some specific cases such as Budd-Chiari syndrome, extracorporeal circulation during the anhepatic phase has to be considered for the maintenance of hemodynamic stability. Recipient hepatectomy followed by outflow (inferior vena cava) and portal vein reconstruction then reperfusion of the graft is performed under serious monitoring of an individual. Restoration of coagulation function of the liver varies according to the graft condition and arterial reconstruction of the graft required prior to control minor bleeders. Attempt to meticulous bleeding control before entire vascular reconstruction seems inefficient. Duct-to-duct anastomosis in biliary reconstruction is a general trend.