CPT® Code 48551

Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile duct, ligation of mesenteric vessels, and Y-graft arterial anastomoses from iliac artery to superior mesenteric artery and to splenic artery

The CPT® Code 48551 refers to the backbench standard preparation of a cadaver donor pancreas allograft prior to transplantation. This procedure is critical in ensuring that the pancreas is adequately prepared for successful transplantation into a recipient. The process begins with the careful removal of the pancreas from its sterile container, where it is then placed on ice and immersed in a cold preservation solution to maintain its viability. A thorough inspection of the pancreas is conducted to confirm that it is intact and suitable for transplant. This preparation involves several intricate steps, including the removal of the attached spleen through the careful ligation and division of splenic vessels, as well as the opening of the duodenum to locate the sphincter of Oddi. A catheter is utilized to navigate through the common bile duct, confirming the correct positioning of the sphincter. The duodenum is then shortened at both ends, and the mesenteric vessels are ligated and divided to facilitate the separation of the duodenum from the distal pancreas. The remaining duodenum is secured by stapling and oversewing its ends. Additionally, the common bile duct is ligated, and the middle colic vessels are ligated at the base of the transverse mesocolon, along with the superior mesenteric vessels at the root of the small bowel mesentery. A Y-graft is constructed to connect the external and internal iliac arteries to the superior mesenteric artery, ensuring proper vascular supply to the pancreas. Throughout this meticulous preparation, the pancreas remains on ice and continues to be bathed in cold preservation solution until the recipient is ready for transplantation.