The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on ex-vivo hepatic resection and reimplantation for liver cancer.


The liver may be affected by cancer, either spreading from other parts of the body or developing from within the organ. In some patients, the tumour may develop in parts of the liver that are dangerous or impossible to treat with surgery, for example, when the tumour is very close to major veins that connect to the liver. This procedure involves removing the liver from the body, cutting away the diseased tissue, and reimplanting the remaining tumour-free liver into the patient.

Coding recommendations

A code from one of the following OPCS-4 categories is selected:

J02.- Partial excision of liver

Y05.4 Ex vivo resection of organ NOC


J03.- Extirpation of lesion of liver

Y05.4 Ex vivo resection of organ NOC

In addition the ICD-10 code C22.9 Malignant neoplasm of liver, unspecified or C78.7 Secondary malignant neoplasm of liver and intrahepatic bile duct would be recorded.

The NHS Classifications Service has advised NICE that currently these are the most suitable OPCS-4 codes to describe this procedure. The OPCS-4 classification is designed to categorise procedures for analysis and it is not always possible to identify a procedure uniquely.

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