CPT® Code 47145

Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with lobe split of whole liver graft into 2 partial liver grafts (ie, left lobe [segments II, III, and IV] and right lobe [segments I and V through VIII])

The procedure described by CPT® Code 47145 involves the meticulous preparation of a cadaver donor's whole liver graft prior to its transplantation into a recipient. This process is commonly referred to as backbench or back table preparation. During this procedure, the liver may be received with the gallbladder still attached; if so, a cholecystectomy, or gallbladder removal, is performed as part of the preparation. The surrounding soft tissues are carefully dissected away to expose critical vascular structures, including the vena cava, portal vein, hepatic artery, and common bile duct, which are essential for the successful implantation of the liver graft. The preparation also includes a lobe split of the whole liver graft into two partial liver grafts: the left lobe, which comprises segments II, III, and IV, and the right lobe, which includes segments I and V through VIII. This splitting of the liver allows for the potential transplantation of the graft into two separate patients, thereby maximizing the utility of the donor organ. The procedure is complex and requires a thorough understanding of liver anatomy and surgical techniques to ensure that all necessary structures are adequately prepared for transplantation, while also minimizing the risk of complications during and after the procedure.