Liver Transplant Surgery in Dhaka

Liver transplantation replaces a diseased or failing liver with a healthy liver from a donor. The procedure involves removing the recipient's native liver (hepatectomy), implanting the donor liver, and reconnecting the hepatic artery, portal vein, bile duct, and inferior vena cava with microsurgical precision.

Dr. Arefin's fellowship training in liver transplantation includes expertise in both deceased donor and living donor liver transplant (LDLT) techniques. He ensures that every anastomosis is performed with meticulous attention to detail, minimising the risk of vascular and biliary complications.

In Bangladesh, living donor liver transplantation is the predominant option due to limited deceased donor organ availability. A healthy adult donates a portion of their liver (typically the right lobe, 60–70% of liver volume), which regenerates in both donor and recipient over 6–12 weeks.

Deceased donor transplantation uses a whole liver from a brain-dead donor. Dr. Arefin evaluates donor organ quality, cold ischaemia time, and recipient urgency to optimise outcomes. He advocates for ethical organ donation practices and transparent recipient selection.

The transplant operation typically lasts 8–12 hours. It begins with the recipient hepatectomy — often challenging due to portal hypertension, collateral vessels, and previous surgery. The donor liver is then implanted with sequential vascular and biliary reconstruction.

Dr. Arefin uses modern techniques including piggyback caval reconstruction, duct-to-duct biliary anastomosis (when anatomy permits), and Roux-en-Y hepaticojejunostomy for complex cases. Intraoperative Doppler ultrasound confirms vascular patency before closure.