CPT® Code 47146

The procedure described by CPT® Code 47146 involves the backbench reconstruction of a liver graft, which can be sourced from either a cadaver or a living donor, prior to its transplantation into a recipient. This intricate surgical process is essential for ensuring that any anatomical variations in the venous or arterial blood supply to the donor liver are properly identified and reconstructed. During this back table procedure, the hepatic venous drainage is meticulously inspected, allowing the surgical team to correct any anatomical anomalies by reconstructing and anastomosing the abnormal vessels to the hepatic venous drainage system. The common hepatic artery, which is one of the three branches of the celiac artery, typically serves as the primary blood supply to the liver. However, it is important to note that the liver may also receive blood supply from the other two branches of the celiac artery, namely the splenic and gastric arteries, or even from the superior mesenteric artery. These alternative arterial sources are preserved during the procedure and are revascularized by connecting them to the main hepatic circulation. For accurate coding, the CPT® Code 47146 should be utilized for each venous anastomosis performed during this reconstruction process, while CPT® Code 47147 is designated for each arterial anastomosis that may be necessary.