OBJECTIVE: The authors objective is to report their recent experience with split-liver transplantation, focusing on the results and the impact on organ shortage. SUMMARY BACKGROUND DATA: There is an insufficient number of organs for liver transplantation. Split-liver transplantation is a method to increase the number of grafts, but the procedure is slow to gain wide acceptance because of its complexity and the poor results reported in previous series. METHODS: During the year 1995, the authors split 20 of 83 transplantable livers allocated to the authors' center, generating 40 grafts: 23 were transplanted locally and 17 were given to partner centers. During the same period, the authors accepted four split-liver grafts proposed to them by other centers. Overall, 27 split-liver transplantations were done in the authors' unit, accounting for 30% of the 90 transplants performed in 1995. RESULTS: One-year patient and graft survival rates for split-liver transplantation were 79.4% and 78.5%, respectively. Arterial and biliary complications rates were 15% and 22%, respectively, with none leading to graft loss. Primary nonfunction occurred in one case (4%). By splitting 24 of 87 transplantable livers (4 of which were in partner units), a total of 111 transplantations were performed, increasing graft availability by 28%. CONCLUSIONS: Split-liver transplantation is achieving graft and patient survival rates similar to that of whole liver transplantation despite a higher incidence of complications, which could become less frequent as experience is gained with this procedure. A wider acceptance of split-liver transplantation could markedly increase the supply of liver grafts.
OBJECTIVE: The authors objective is to report their recent experience with split-liver transplantation, focusing on the results and the impact on organ shortage. SUMMARY BACKGROUND DATA: There is an insufficient number of organs for liver transplantation. Split-liver transplantation is a method to increase the number of grafts, but the procedure is slow to gain wide acceptance because of its complexity and the poor results reported in previous series. METHODS: During the year 1995, the authors split 20 of 83 transplantable livers allocated to the authors' center, generating 40 grafts: 23 were transplanted locally and 17 were given to partner centers. During the same period, the authors accepted four split-liver grafts proposed to them by other centers. Overall, 27 split-liver transplantations were done in the authors' unit, accounting for 30% of the 90 transplants performed in 1995. RESULTS: One-year patient and graft survival rates for split-liver transplantation were 79.4% and 78.5%, respectively. Arterial and biliary complications rates were 15% and 22%, respectively, with none leading to graft loss. Primary nonfunction occurred in one case (4%). By splitting 24 of 87 transplantable livers (4 of which were in partner units), a total of 111 transplantations were performed, increasing graft availability by 28%. CONCLUSIONS: Split-liver transplantation is achieving graft and patient survival rates similar to that of whole liver transplantation despite a higher incidence of complications, which could become less frequent as experience is gained with this procedure. A wider acceptance of split-liver transplantation could markedly increase the supply of liver grafts.
Authors: J C Emond; P F Whitington; J R Thistlethwaite; D Cherqui; E A Alonso; I S Woodle; P Vogelbach; S M Busse-Henry; A R Zucker; C E Broelsch Journal: Ann Surg Date: 1990-07 Impact factor: 12.969
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Authors: R J Stratta; R P Wood; A N Langnas; R R Hollins; K J Bruder; J P Donovan; D A Burnett; R P Lieberman; G B Lund; T J Pillen Journal: Surgery Date: 1989-10 Impact factor: 3.982
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: Dieter C Broering; Christian Wilms; Christian Lenk; Jan Schulte am Esch; Silke Schönherr; Lars Mueller; Jong-Sun Kim; Knut Helmke; Martin Burdelski; Xavier Rogiers Journal: Ann Surg Date: 2005-12 Impact factor: 12.969
Authors: D Azoulay; D Castaing; R Adam; E Savier; V Delvart; V Karam; B Y Ming; M Dannaoui; J Krissat; H Bismuth Journal: Ann Surg Date: 2001-04 Impact factor: 12.969