Related Experiment Video
Updated: May 12, 2026
Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt
Published on: May 7, 2015
Combined en bloc heart and liver organ procurement
Yuriy Stukov1, Mark Bleiweis2, Werviston De Faria3
1Division of Thoracic Surgery, Department of Surgery, University of Florida, Gainesville, Florida, USA.
Insights
Combined heart and liver transplants offer survival for patients with end-stage cardiac and hepatic disease. This video details the en bloc procurement technique, minimizing cold ischemia time for both organs.
Area of Science:
- Cardiovascular Surgery
- Hepatobiliary Surgery
- Transplant Surgery
Background:
- Combined heart and liver disease necessitates combined transplantation for survival.
- Etiologies of hepatic disease are diverse, including systemic conditions and venous congestion from univentricular circulation.
- Patients with univentricular circulation may require complex cardiac reconstruction alongside transplantation.
Discussion:
- The en bloc cardio-hepatectomy technique involves continuous dissection of the aorta, superior vena cava, and pulmonary arteries.
- Parallel organ procurement by cardiac and abdominal teams optimizes efficiency.
- This method aims to reduce cold ischemia time for both the heart and liver.
Key Insights:
- En bloc procurement of heart and liver minimizes organ exposure to cold ischemia.
- The technique is crucial for patients with end-stage combined cardiac and hepatic disease.
- This surgical approach is particularly relevant for patients with univentricular circulation.
Outlook:
- Further refinement of en bloc procurement techniques can improve outcomes for complex transplant cases.
- This approach may be adaptable to other multi-organ procurement scenarios.
- Standardization of this technique could enhance its widespread adoption in specialized transplant centers.
Abstract:
A combined heart+liver transplant is the only option for survival in some patients with end-stage combined cardiac and hepatic disease. These patients may suffer from congenital or acquired cardiac disease. The potential aetiologies of the associated hepatic disease are heterogeneous and include systemic disease that impacts the liver as well as venous congestion in patients with functionally univentricular circulation. In the latter scenario, patients with functionally univentricular circulation often require complex cardiac reconstruction in the setting of a cardiac transplant after staged palliation. During cardiac procurement, our approach is to dissect the entire ascending aorta and aortic arch in continuity; the entire superior caval vein and innominate vein in continuity; and the pulmonary arteries from hilum to hilum if the donor is not a candidate for recovery of the lungs. The cardiac and abdominal organ procurement teams work in parallel during dissection and combined en bloc cardio-hepatectomy. This technique minimizes exposure of both organs to cold ischaemia. This video tutorial demonstrates the key steps for combined en bloc heart+liver organ procurement.
More Related Videos
09:54Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
12:49Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
