Dr. James Vincent Guarrera, MD

For hemodialysis (the more common form of dialysis), a patient will visit a hospital or clinic and be connected to a dialysis machine by a needle attached to a tube that draws blood from the arm. The drawn blood is transferred to the dialysis machine, where it is filtered and separated until clean. Waste products from the blood pass into a fluid called dialysate, which is pumped out of the machine into a waste receptacle. The machine also measures and helps ensure the blood has the appropriate level of fluid, electrolytes, and pH. A tube delivers the cleaned blood back into the patient's body. A dialysis session like this will typically last for three to four hours, with a patient undergoing dialysis around three times per week.

A second method of dialysis is known as peritoneal dialysis. Unlike hemodialysis, peritoneal dialysis can be performed at home by oneself after an initial surgery. To start, a physician (generally a surgeon) will make a small incision in the lower abdomen and insert and surgically attach a catheter (thin tube). At home, the patient connects a pump to the abdomen catheter, delivering dialysate (dialysis fluid) from a bag hanging on a wheeled stand. This fluid enters the peritoneal cavity (greater abdomen area containing the stomach, liver, and intestines) and collects waste through osmosis, where waste in the blood moves across a membrane and into the dialysate. This process continues for several hours until the fluid concentration is equal between the blood and dialysate, at which point the fluid can be drained. The fluid can then be passed through a machine called a cycler, which removes waste and allows for the dialysate to be reused. This process is repeated about four times per day. Dialysis patients must limit the amount of fluid they consume prior to receiving dialysis and should also avoid eating salty foods. The cycler cannot filter more than a certain amount of waste products from the blood.

Kidneys are important organs, and dialysis treatments are vital for those with renal dysfunction. For many, dialysis is not so much a medical procedure but a part of their normal life.

Liver resection can be performed laparoscopically or through open surgery. Laparoscopic liver resection is a minimally invasive surgery that requires a few tiny incisions on the abdomen, through which the surgeon inserts a thin tube with a camera (laparoscope). Open hepatectomy is performed through a laparotomy, which makes one large incision on the abdomen. Although a laparoscopic liver resection is associated with less pain and quicker recovery, patients may have to undergo an open liver resection depending on factors such as the location of the tumor and previous abdominal operations they have had.

After the liver resection, patients will stay in the hospital for up to six days. The recovery period will vary based on how much of the liver was removed. Limiting consumption of alcohol and light physical activity, such as walking, can help patients to have a speedy recovery.

To perform radioembolization, a catheter is inserted into an artery in the groin and threaded to the liver. Radioactive beads, or pellets, are delivered through the catheter. The pellets will continuously deliver radiation for 10-14 days. The pellets will remain in the body permanently without causing any complications. If the tumor or cancer is confined to one portion of the liver, radioembolization will be performed in one treatment session. If both sides of the liver are affected, a second treatment session will be done about 8 weeks after the first.

Typically, most patients can return home and do light activity within hours following the procedure. Patients will be given medication to treat any possible side effects, which can include nausea, fever, abdominal pain, or tiredness.