Some Details About the Surgery

Some questions I've been getting lately include what happens during surgery, after, how long will we be in the hospital, etc.

Surgery for the donor begins first. I report to the hospital at 5am eastern on the 22nd. I will be taken to the holding area around 6:30am to meet with the anesthesiologist who will place an epidural catheter for pain control and start an IV. I will then be taken to the OR suite. I have been told my surgery will begin about 7:30am. Thatcher’s surgery begins a couple hours later.

The liver has two lobes; a right and left which each have their own blood source. The gallbladder is attached to the left lobe. The donor will have what is called a “partial hepatectomy” – the surgical removal of part of the left lobe of the liver. Once asleep from the anesthesia, a breathing tube is placed down my throat, which is removed sometime after surgery.The surgeons will make an incision across the abdomen, just below the ribs to safely locate and remove the gallbladder and portion of the liver. It is necessary to remove the gallbladder since it is located under the part of the liver that will be removed. The surgeons remove about 25% of the donor’s liver and the gallbladder.

I’ll have a catheter to drain urine and another tube inserted through my nose and throat to my stomach to drain fluids (NG tube) so I don’t get sick during surgery. The NG tube stays in place for 1-2 days after surgery until the bowels begin working again. During surgery, a small plastic drain (JP drain) will be placed near the abdomen incision to allow fluids to be drained while healing after surgery. The drain is usually taken out about 5 days post surgery. The operation takes 5-10 hours.

Much of this is true for Thatcher’s surgery as well (catheter, NG tube, JP drain, etc.). They'll remove all of Thatcher’s liver and replace it with my left lobe. The liver will regenerate in both of us and should return to normal size in about 2-3 months. The part of the liver that was taken out does not grow back. What is left of the liver grows to fill the space of the part that was removed. In fact, my 25% may still be too large for Thatcher so he will have to grow into it. Many times, the recipient comes out of surgery partially open a few days, while the swelling goes down, before completely being stitched up.

My scar is commonly referred to as a "mercedes scar" because it looks like the Mercedes Benz emblem (minus the outside circle). They will re-open Thatcher’s previous incision and continue across to the other side.

There are no long term side effects from my surgery. I won't need special medicine and won't need to change how I eat or live except for the short term...no alcohol for the months immediately prior and after surgery (I guess I did it for the 9 months he was in the womb, what’s a few more months!)

Like any surgery, there are risks, the handout I got on my surgery said the most common liver related risks include bile leakage where bile may leak from where the surface of the liver was or bile duct was cut (5-15% chance). Another possible complication is bleeding since the liver has a very rich blood supply. Other possible complications that may occur after surgery are the development of a hernia (if the muscles don’t heal properly), infection, and blood clots in the legs. Thus far, the death rate in the US for a living liver donor is about .2% chance...it’s even lower for pediatric living donor because they have to take less of my liver.

We are terrified, excited, anxious, and all of the above. We are also hopeful. The odds are much better this time around than with Thatcher's first procedure with success rates for 1 to 3 year survival rates in the 90th percentile. Please continue to pray for strength and healing for our family.

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