BACKGROUND: Split liver transplantation (SLT) for two adult recipients is still considered a challenging procedure, especially when subjected to model for end-stage liver disease (MELD)-based allocation criteria. METHODS: Twenty-two SLTs were performed in adult recipients in a European center operating within a MELD-oriented system. Thirteen right-sided grafts and nine left-sided grafts were used. Right-sided grafts included 11 extended right grafts and two full right grafts. Left-sided grafts included six left lateral segment grafts and three full left grafts. Ninety-three percent of donors were allocated based on MELD score. Median graft-to-recipient body weight ratio was 1.53 (range 1.07-2.11) with right-sided grafts and 0.81 (range 0.67-1.11) with left-sided grafts. Liver cirrhosis (46%) and metabolic/genetic disorders (56%) were the main indications for transplant in recipients of right and left grafts, respectively. RESULTS: Overall patient and graft survival were 90% and 86%. Patient survival was 84% in recipients of right grafts and 100% in recipients of left grafts. Graft survival was 84% and 89%, respectively. Vascular and biliary complications occurred in 14% and 4% of cases. Postoperative serum levels of total bilirubin were significantly higher in recipients of left-sided grafts versus right-sided grafts on postoperative days 7 and 14. Prothrombin activity was significantly lower in recipients of left-sided grafts versus right-sided grafts on postoperative days 3 and 7. CONCLUSIONS: SLT for two adult recipients can be successfully performed even using left lateral segments by assigning one graft according to MELD score, and with a more liberal allocation of the second graft.
BACKGROUND: Split liver transplantation (SLT) for two adult recipients is still considered a challenging procedure, especially when subjected to model for end-stage liver disease (MELD)-based allocation criteria. METHODS: Twenty-two SLTs were performed in adult recipients in a European center operating within a MELD-oriented system. Thirteen right-sided grafts and nine left-sided grafts were used. Right-sided grafts included 11 extended right grafts and two full right grafts. Left-sided grafts included six left lateral segment grafts and three full left grafts. Ninety-three percent of donors were allocated based on MELD score. Median graft-to-recipient body weight ratio was 1.53 (range 1.07-2.11) with right-sided grafts and 0.81 (range 0.67-1.11) with left-sided grafts. Liver cirrhosis (46%) and metabolic/genetic disorders (56%) were the main indications for transplant in recipients of right and left grafts, respectively. RESULTS: Overall patient and graft survival were 90% and 86%. Patient survival was 84% in recipients of right grafts and 100% in recipients of left grafts. Graft survival was 84% and 89%, respectively. Vascular and biliary complications occurred in 14% and 4% of cases. Postoperative serum levels of total bilirubin were significantly higher in recipients of left-sided grafts versus right-sided grafts on postoperative days 7 and 14. Prothrombin activity was significantly lower in recipients of left-sided grafts versus right-sided grafts on postoperative days 3 and 7. CONCLUSIONS: SLT for two adult recipients can be successfully performed even using left lateral segments by assigning one graft according to MELD score, and with a more liberal allocation of the second graft.
Authors: Andrea Lauterio; Stefano Di Sandro; Giacomo Concone; Riccardo De Carlis; Alessandro Giacomoni; Luciano De Carlis Journal: World J Gastroenterol Date: 2015-10-21 Impact factor: 5.742
Authors: Douglas B Mogul; Xun Luo; Jacqueline Garonzik-Wang; Mary G Bowring; Allan B Massie; Kathleen B Schwarz; Andrew M Cameron; John F P Bridges; Dorry L Segev Journal: Liver Transpl Date: 2019-01 Impact factor: 5.799
Authors: Harald Schrem; Moritz Kleine; Tim Oliver Lankisch; Alexander Kaltenborn; Lampros Kousoulas; Lea Zachau; Frank Lehner; Jürgen Klempnauer Journal: World J Surg Date: 2014-07 Impact factor: 3.352
Authors: Matteo Ravaioli; Matteo Serenari; Matteo Cescon; Sofia Martin Suarez; Alessandro Cucchetti; Giorgio Ercolani; Massimo Del Gaudio; Fausto Catena; Cristina Morelli; Giorgio Arpesella; Antonio Daniele Pinna Journal: Case Rep Transplant Date: 2012-10-11