CPT® Code 47133

The procedure described by CPT® Code 47133 refers to a donor hepatectomy, which is the surgical removal of the liver from a cadaver donor for the purpose of transplantation. This complex surgical operation involves several critical steps to ensure the liver is preserved adequately for future transplantation into a recipient. The term 'cold preservation' indicates that the liver is cooled to slow down metabolic processes, thereby extending the viability of the organ during transport. The procedure begins with a midline incision that extends from the substernal notch down to the pubis, allowing access to the abdominal cavity. During the operation, various anatomical structures are carefully identified and preserved, including the round and falciform ligaments, which support the liver, and the major blood vessels supplying the liver, such as the left hepatic artery, common hepatic artery, and right hepatic artery. The common bile duct is also divided, and the gallbladder is flushed to prepare the organ for preservation. The surgical team meticulously isolates the distal aorta and inferior mesenteric vein, ligating specific arteries to prevent blood flow during the removal process. Once the liver is fully dissected from its vascular connections, the aorta is cross-clamped to facilitate the instillation of preservation solution into the aortic and portal veins. Finally, the liver is removed from the donor's body and packed in ice to maintain its integrity until it can be transplanted into a recipient.