CPT® Code 47136

Deleted

The procedure described by CPT® Code 47136 refers to liver allotransplantation, specifically a heterotopic transplantation, which can involve either a partial or whole liver from a cadaver or living donor, regardless of the donor's age. In this surgical procedure, the liver is accessed through a bilateral subcostal incision that may extend into the upper midline, allowing the surgeon to expose the liver adequately. Unlike orthotopic transplantation, where the diseased liver is removed, in heterotopic transplantation, the diseased liver remains in place. Instead, the donor liver is positioned in an ectopic site, which is as close to the recipient's liver as possible. This technique involves intricate surgical steps, including the anastomosis of the vascular structures of the donor liver to the recipient's blood vessels, ensuring proper blood flow. The arterial and portal venous inflow is sourced from the infrarenal aorta and the superior mesenteric vein, while the venous outflow from the donor liver is directed into the recipient's infrarenal inferior vena cava. Additionally, the donor bile duct is connected to either the recipient bile duct or the jejunum, and a T-tube is placed in the bile duct for external drainage. Post-surgery, drains may be inserted into the abdomen as necessary, and the abdominal incision is subsequently closed. This procedure is complex and requires careful planning and execution to ensure successful transplantation and recovery.