OBJECTIVE: To analyze the outcome of 80 consecutive pediatric split liver transplants performed at the authors' center between 1994 and 2000. SUMMARY BACKGROUND DATA: Split liver transplantation has become an accepted method of increasing the number of available grafts for pediatric liver transplant recipients. METHODS: The age of the patients at the time of transplantation ranged from 5 days to 16 years (median 3 years). Sixteen transplants were performed for acute liver failure and 64 for chronic liver failure. The ex situ splitting technique was used for all but four grafts. Fourteen livers were split for two pediatric recipients. Posttransplant follow-up ranged from 6 to 84 months (median 42 months). RESULTS: Overall patient survival at 6 months follow-up was 96.2%. Graft survival at six months was 93.7%. The Kaplan-Meier patient survival rates at 1 and 3 years were 93.5% and 88.1%, and the graft survival rates were 89.7% and 86.1%, respectively. Four patients required retransplantation. In the acute group (n = 16), the patient survival rates were 93.7% at 1 year and 76.4% at 3 years; there were three deaths due to posttransplant lymphoproliferative disease (PTLD), sepsis, and chronic rejection. In the chronic group (n = 64), the 1- and 3-year patient survival rates were 93.6% and 90.9%, respectively. There were six deaths in this group. Four patients died in the first year after the transplant due to intracranial bleeding, cerebral tumor recurrence, PTLD, and chronic rejection. There were two deaths at 3 years, one due to progressive renal failure secondary to cyclosporin toxicity and the other due to sepsis, portal hypertension, and recurrent bleeding. Vascular complications occurred in six (7.5%) patients and biliary complications in seven (8.7%). CONCLUSIONS: These results, which represent the experience of a single institution over the last 6 years, indicate that ex situ split liver transplantation can be performed in children with good overall outcome and acceptable morbidity.
OBJECTIVE: To analyze the outcome of 80 consecutive pediatric split liver transplants performed at the authors' center between 1994 and 2000. SUMMARY BACKGROUND DATA: Split liver transplantation has become an accepted method of increasing the number of available grafts for pediatric liver transplant recipients. METHODS: The age of the patients at the time of transplantation ranged from 5 days to 16 years (median 3 years). Sixteen transplants were performed for acute liver failure and 64 for chronic liver failure. The ex situ splitting technique was used for all but four grafts. Fourteen livers were split for two pediatric recipients. Posttransplant follow-up ranged from 6 to 84 months (median 42 months). RESULTS: Overall patient survival at 6 months follow-up was 96.2%. Graft survival at six months was 93.7%. The Kaplan-Meier patient survival rates at 1 and 3 years were 93.5% and 88.1%, and the graft survival rates were 89.7% and 86.1%, respectively. Four patients required retransplantation. In the acute group (n = 16), the patient survival rates were 93.7% at 1 year and 76.4% at 3 years; there were three deaths due to posttransplant lymphoproliferative disease (PTLD), sepsis, and chronic rejection. In the chronic group (n = 64), the 1- and 3-year patient survival rates were 93.6% and 90.9%, respectively. There were six deaths in this group. Four patients died in the first year after the transplant due to intracranial bleeding, cerebral tumor recurrence, PTLD, and chronic rejection. There were two deaths at 3 years, one due to progressive renal failure secondary to cyclosporintoxicity and the other due to sepsis, portal hypertension, and recurrent bleeding. Vascular complications occurred in six (7.5%) patients and biliary complications in seven (8.7%). CONCLUSIONS: These results, which represent the experience of a single institution over the last 6 years, indicate that ex situ split liver transplantation can be performed in children with good overall outcome and acceptable morbidity.
Authors: J A Goss; H Yersiz; C R Shackleton; P Seu; C V Smith; J S Markowitz; D G Farmer; R M Ghobrial; J F Markmann; W S Arnaout; D K Imagawa; S D Colquhoun; M H Fraiman; S V McDiarmid; R W Busuttil Journal: Transplantation Date: 1997-09-27 Impact factor: 4.939
Authors: M Kalayoglu; A M D'Alessandro; S J Knechtle; R M Hoffmann; J D Pirsch; R H Judd; M Armbrust; E Spaith; G Pilli; C J Young; S R Geffner; J S Odorico; H W Sollinger; F O Belzer Journal: J Am Coll Surg Date: 1996-05 Impact factor: 6.113
Authors: M Rela; P Muiesan; V Bhatnagar; A Baker; A P Mowat; G Mieli-Vergani; J Karani; R Williams; N D Heaton Journal: Transplantation Date: 1996-05-15 Impact factor: 4.939
Authors: V Bhatnagar; A Dhawan; H Chaer; P Muiesan; M Rela; A P Mowat; R Williams; K C Tan; N D Heaton Journal: Transpl Int Date: 1995 Impact factor: 3.782
Authors: X Rogiers; M Malagó; K Gawad; K W Jauch; M Olausson; W T Knoefel; M Gundlach; A Bassas; L Fischer; M Sterneck; M Burdelski; C E Broelsch Journal: Ann Surg Date: 1996-09 Impact factor: 12.969
Authors: Salvatore Gruttadauria; Fabrizio di Francesco; Duilio Pagano; Sergio Li Petri; Davide Cintorino; Marco Spada; Bruno Gridelli Journal: World J Gastrointest Surg Date: 2010-03-27
Authors: Matteo Cescon; Marco Spada; Michele Colledan; Giuliano Torre; Enzo Andorno; Umberto Valente; Giorgio Rossi; Paolo Reggiani; Umberto Cillo; Umberto Baccarani; Gian Luca Grazi; Giuseppe Tisone; Franco Filipponi; Massimo Rossi; Giuseppe Maria Ettorre; Mauro Salizzoni; Oreste Cuomo; Tullia De Feo; Bruno Gridelli Journal: Ann Surg Date: 2006-11 Impact factor: 12.969
Authors: Robert S Venick; Douglas G Farmer; Sue V McDiarmid; John P Duffy; Sherilyn A Gordon; Hasan Yersiz; Johnny C Hong; Jorge H Vargas; Marvin E Ament; Ronald W Busuttil Journal: Transplantation Date: 2010-03-15 Impact factor: 4.939
Authors: Christian Wilms; Jessica Walter; Maren Kaptein; Lars Mueller; Christian Lenk; Martina Sterneck; Christian Hillert; Lutz Fischer; Xavier Rogiers; Dieter C Broering Journal: Ann Surg Date: 2006-12 Impact factor: 12.969
Authors: Marco Spada; Silvia Riva; Giuseppe Maggiore; Davide Cintorino; Bruno Gridelli Journal: World J Gastroenterol Date: 2009-02-14 Impact factor: 5.742