What I know: surgery

About the surgery is pretty limited. Duh. Being sent to the depths of sleep will do that to a girl.

But here's a good link, which backs up what I knew beforehand. The pictures are gross...

http://www.surgery.usc.edu/divisions/hep/patientguide/livertransplanttour.html

but anyway.

One thing they do is re-route the inferior vena cava, which conveniently goes between the liver's lobes and drains all the used blood from the lower half of the body back to the heart. So re-route might be a bad word, but clamp it off and send it elsewhere? I don't think they do bypass, or at least not on me, because I don't have the commensurate "holes" for the tubing (e.g., a notch in my upper right thigh.), I don't think. Anyhow, they do that relatively soon after the incision, then get about detaching the liver itself.

Another thing that happens to liver tx recipients is that they forevermore do not have a gallbladder. The old one has to go, and the new one can't be transplanted, so there you have it.

When they are attaching the new liver, they see how functional the common bile duct is -- the spot where the intestines connect to the liver and/or the gall bladder. Mine had been, er, damaged might be the best word, or well-used, due to a series of ERCP's (the short name for a long procedure that involves swallowing a camera that then takes a right turn into the bile duct). Therefore I know that the surgeon had to create a new connection using a nearby stretchy piece of my intestines. Ick!

I was in surgery 11.5 hours, give or take. Apparently there was a big clot in my portal vein (? yes? I think that and not the hepatic artery) that took time to clean out. I didn't ask whether the clot was on "my" side or on the graft's side, but blood doing what it does, having pooled there for awhile, there was a clot. I am now wondering if that is related to the stricture that may or may not be there...

Some time I am going to read my medical record so that I know more. I am curious as to what my old liver looked like, and did they do any pathology with it? I want the chronology, just because.

And that's all I know for now. When I emerged I had a central line with 5 tubes on the right side of my neck (resulting in a great vampire scar!), the naso-gastric tube, the entubation/breathing tube, an incision which I have yet to measure or count the staple marks, two Jackson-Pratt drains (more on those later), a catheter, and at least one additional IV. I think I am glad that I was unconscious.