The standard technical procedure of a piggyback total hepatectomy includes preservation of the native inferior vena cava and a temporary end-to-side portocaval shunt, according to the surgeon’s preference and the liver transplantation scenario. During the recipient total hepatectomy, each element of the hepatic pedicle (hepatic artery, bile duct, and portal vein) is dissected, ligated, and transected. The retrohepatic inferior vena cava is then dissected, and the native liver is progressively separated from the native inferior vena cava.