BACKGROUND: To expand the donor pool, split liver transplantation is conventionally performed for one adult and one pediatric recipient. Application of this technique for two adult recipients can produce remarkable impact on the waiting list. Proper donor and recipient selection is crucial for the favorable outcome following full-right and full-left liver split. Right lobe adult to adult living donor liver transplantation (LDLT) is essentially a full right and full left split. However, LDLT techniques have not been used for full right and left split. METHODS: We performed in situ splitting of the whole liver using LDLT techniques from a hemodynamically stable young deceased donor and transplanted into two adult recipients, both with model for end-stage liver disease score of 17. The transection was carried out through the midplane of liver, generating a right lobe and a left lobe graft. RESULTS: Both the recipients had uneventful postoperative recovery. At ten months of follow up, both the recipients are doing well with good liver function. CONCLUSION: Based on the concept of living related liver transplantation, our case explores the technical feasibility of full-right and full-left in situ liver split.
BACKGROUND: To expand the donor pool, split liver transplantation is conventionally performed for one adult and one pediatric recipient. Application of this technique for two adult recipients can produce remarkable impact on the waiting list. Proper donor and recipient selection is crucial for the favorable outcome following full-right and full-left liver split. Right lobe adult to adult living donor liver transplantation (LDLT) is essentially a full right and full left split. However, LDLT techniques have not been used for full right and left split. METHODS: We performed in situ splitting of the whole liver using LDLT techniques from a hemodynamically stable young deceased donor and transplanted into two adult recipients, both with model for end-stage liver disease score of 17. The transection was carried out through the midplane of liver, generating a right lobe and a left lobe graft. RESULTS: Both the recipients had uneventful postoperative recovery. At ten months of follow up, both the recipients are doing well with good liver function. CONCLUSION: Based on the concept of living related liver transplantation, our case explores the technical feasibility of full-right and full-left in situ liver split.
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Keywords:
CHD, common hepatic duct; GRWR, graft/recipient's body weight ratio; IVC, inferior vena cava; LDLT, living donor liver transplantation; LHA, left hepatic artery; LHD, left hepatic duct; LHV, left hepatic vein; MELD score; MELD, model for end-stage liver disease; MHV, middle hepatic vein; MPV, main portal vein; RHA, right hepatic artery; RHV, right hepatic vein; SLT, split liver transplantation; deceased donor; partial grafts; split liver transplantation; waiting list
Authors: A Humar; T Ramcharan; T D Sielaff; R Kandaswamy; R W Gruessner; J R Lake; W D Payne Journal: Am J Transplant Date: 2001-11 Impact factor: 8.086
Authors: Matteo Cescon; Gian Luca Grazi; Matteo Ravaioli; Giorgio Ercolani; Massimo Del Gaudio; Marco Vivarelli; Alessandro Cucchetti; Matteo Zanello; Gaetano Vetrone; Augusto Lauro; Antonio Daniele Pinna Journal: Transplantation Date: 2009-11-15 Impact factor: 4.939