Transplantation for Liver & Bile Duct Cancers

Doctors at NYU Langone’s Transplant Institute may recommend liver transplantation for people with early liver cancer, especially those who also have severe cirrhosis, or scarring of the organ. Some people with bile duct cancer that cannot be resected, or removed, by surgery, may be eligible for a liver transplant.

Transplantation is usually reserved for people with liver cancer who have 1 tumor that is up to 5 centimeters in diameter, or 2 or 3 tumors that are each less than 3 centimeters in diameter.

Eligibility

To receive a liver transplant, a person must be in good health, without significant lung or heart disease. In addition, the cancer must be localized, meaning it has not spread beyond the liver.

Doctors also want to make sure that a potential recipient of a new liver is ready to care for it. A transplant recipient must take lifelong immune-suppressing medication so that their body doesn’t reject the new organ.

Liver Donation

A donated liver often comes from a deceased donor—a person who has just died. The wait time can be as long as one to two years through donor registries. It often depends on how long it takes to find the right match for your blood and tissue type and body size.

While you wait, our doctors may provide other treatments, such as ablation or embolization, to manage liver tumors and help prevent them from growing.

Some people may be able to bypass the transplant waiting list by using a donated portion of a liver from a living person who is a blood and tissue match. This is usually a close blood relative, such as a parent, sibling, or son or daughter. The transplanted portion of the liver regenerates and grows to an appropriate size in the recipient.

NYU Langone was one of the first medical centers in the country to implement a living donor liver transplant program.

Transplantation Surgery

When an organ has been found, NYU Langone’s transplantation team prepares you for surgery. If a liver from a deceased donor becomes available, you need to get to the hospital as soon as possible. Most organs must be transported from another medical facility and can be preserved for only up to eight hours.

If the liver comes from a living donor, the timing of the procedure can be planned, so that you and the donor have surgery at the same time.

To perform a liver transplant, a surgeon makes an incision several inches long in the right side of the recipient’s abdomen under the ribs. He or she removes the cancerous liver from the body by carefully cutting the organ’s blood vessels and bile ducts. The surgeon clamps the vessels and ducts to prevent bleeding and leaking of bile.

Next, the donor liver is connected to the recipient’s blood vessels and bile ducts. On average, liver transplant surgery takes four to eight hours.

Recovery from Transplantation Surgery

After a liver transplant, you may stay in the hospital for one to two weeks or longer. During this time, doctors observe you to ensure your immune system does not reject the new liver. If your body starts to do so, your doctor can treat you with medication. Your doctor also prescribes medication to prevent infection after transplantation.

Initially, follow-up with your transplant physician occurs on a weekly basis. During these visits, your doctor ensures that you are healing and adjusts your medications, if needed. People who have the procedure are able to return to work and their daily routine after leaving the hospital. About 85 percent of transplanted livers are still functioning 1 year after surgery.

Members of NYU Langone’s liver transplantation team provide care from the time of referral for surgery to recovery. These experts include surgeons and specialists in transplant hepatology, who help select donor livers and care for recipients; cardiology; hematology; neurology; pathology; anesthesiology; radiology; and immunology. Our nurse practitioners and transplant social workers, pharmacists, nutritionists, and financial coordinators guide you through the process.

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