Back to Search
Start Over
Improved results for adult split liver transplantation with extended right lobe grafts: could we enhance its application?
- Source :
- Transplantation proceedings. 41(8)
- Publication Year :
- 2009
-
Abstract
- Objective. Split liver transplantation (SLT) allows grafting of 2 recipients with 1 allograft. Results of adult SLT have improved since its first introduction. Children benefit most from SLT, while among some adult liver transplanters there are concerns about splitting a liver, turning a good quality graft into a marginal one. We performed a single center retrospective review to address this issue. Patients and Methods. Between June 2001 and August 2008, we performed 22 extended right liver graft (eRLG) transplantations in 21 adult patients. Results. Eleven donors (50%) did not meet the Eurotransplant criteria for optimal donors. Forty-one percent of eRLG donors showed hemodynamic instability at the time of harvest. Eighteen (82%) splitting procedures were performed ex situ. The main indications for transplantation were alcoholic liver cirrhosis (32%), hepatitis C-related cirrhosis (18%), and acute liver failure (18%). Mean recipient age was 54 years (range, 17-69 years); median Model for End-Stage Liver Disease (MELD) score was 15 (range, 7-40). Patients were followed for a median of 16 months (range, 4-92 months) following transplantation. We observed 5 (23%) vascular and 3 (14%) biliary complications. Overall patient survival was 84% at 3 years; overall graft survival was 79%. For the 11 patients who had undergone transplantation after 2007, we observed a 100% patient and graft survival. Conclusion. After an initial learning curve and provided careful selection, exceptions to classical donor criteria for splitting can be accepted with successful outcomes comparable to those after whole liver transplantation.
- Subjects :
- Adult
Brain Death
medicine.medical_specialty
Cirrhosis
Tissue and Organ Procurement
medicine.medical_treatment
Liver transplantation
Single Center
Liver disease
Liver Cirrhosis, Alcoholic
medicine
Hepatectomy
Humans
Transplantation, Homologous
Survivors
Child
Survival analysis
Aged
Retrospective Studies
Hepatitis
Transplantation
business.industry
Patient Selection
Retrospective cohort study
Length of Stay
Liver Failure, Acute
Middle Aged
medicine.disease
Hepatitis C
Survival Analysis
Tissue Donors
Surgery
Liver Transplantation
Survival Rate
Intensive Care Units
Treatment Outcome
Tissue and Organ Harvesting
business
Subjects
Details
- ISSN :
- 18732623
- Volume :
- 41
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Transplantation proceedings
- Accession number :
- edsair.doi.dedup.....1ddb11d38b799c4e93d7e94e09f6acf7