The specimen is received unfixed in four parts.
Part 1 is labeled "liver". It consists of a 1620 gram allograft hepatectomy, 28.0 x 22.0 x 5.0 cm. The capsular surface is smooth, gray and bile stained with soft to friable areas noted throughout. The attached caudate lobe is 6.0 x 3.0 x 2.0 cm. There is approximately 5.0 cm. of attached inferior vena, 7.0 cm. in open circumference with an adherent dark thrombus. The associated hepatic veins are tan-gray and grossly patent. There is no attached gallbladder. On dissection of the superficial hilus, thrombosis of the portal vein is evident. In addition, a 9.0 cm. segment of donor iliac artery anastomosed to the donor hepatic artery also has adherent dark thrombus obstructing approximately 80% of the lumen. The hepatic duct is grossly free of obstruction. A single 2.0 cm. tan lymph node within the surrounding fat has a smooth, tan cut surface. The cut surface of the liver consists of bile-stained, soft to friable parenchyma with occlusion of the arterial and venous branches. The bile ducts are grossly patent, however, and deeply hemorrhagic. Representative tissue is frozen in bulk and stocked in formalin. Gross photos are taken and sections are submitted.
Part 2 is labeled "distal pancreas". It consists of a 105 gram portion of tan and hemorrhagic pancreas with attached fat and soft tissue, 10.0 x 7.0 x 2.5 cm. Gray-yellow fat necrosis is evident on the exterior of the pancreas along with areas of cautery and thrombosis. On serial sectioning, the splenic artery and vein are almost totally occluded by dark thrombus. The pancreas resection margin is tan, irregular, but grossly viable. Gross photos are taken and sections are submitted.
Part 3 is labeled "right lobe of liver". It consists of a single core of bile-stained, soft tissue, 1.2 x 0.1 x 0.1 cm. Totally submitted following frozen section evaluation labeled 3A.
Part 4 is labeled "left lobe of liver". It consists of a single core of similar bile-stained, soft tissue, 1.4 x 0.1 x 0.1 cm. Totally submitted following frozen section evaluation labeled 4A.