CPT® Code 47140

The procedure described by CPT® Code 47140 refers to a donor hepatectomy, specifically the surgical removal of the left lateral segment of the liver, which includes segments II and III, from a living donor. This operation is performed to procure liver tissue for transplantation. The term "hepatectomy" denotes the surgical excision of liver tissue, and in this case, it is conducted on a living donor, meaning that the donor is alive and voluntarily undergoing the procedure to provide a portion of their liver for another individual in need of a transplant. The removed liver segment is then subjected to cold preservation, a technique that involves cooling the liver tissue to prolong its viability for transplantation. During the procedure, a midline incision is typically made, extending from the substernal notch down to the pubis, although an upper midline approach may also be utilized depending on the surgeon's preference and the specific anatomy of the donor. The surgical team carefully exposes and inspects the liver to ensure proper access to the left lateral segment. The mobilization of this segment involves the division of several ligaments that support the liver, allowing for its displacement and the exposure of critical vascular structures. The meticulous dissection of the left branch of the portal vein, the left hepatic duct, and the left branch of the hepatic artery is essential for the safe removal of the liver segment. Following the separation of the liver parenchyma, the hepatic vein is double ligated and transected, completing the excision of the left lateral segment. The segment is then perfused with a cold preservation solution to maintain its integrity until it can be transplanted into the recipient. The procedure concludes with the control of any bleeding, irrigation of the wound, and closure around drains to facilitate recovery.