Logistic aspects and procedures in split liver transplantation

Karbe, T; Broering, DC; Kuetemeier, Robert; Rogiers, Xavier

doi:10.1007/978-3-642-57523-5_3

Cited by 9 publications

(9 citation statements)

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“…The increased blood loss and volume replacement incurred during in situ SLT has prompted concerns that the quality of thoracic organs may be affected (31). Data from our center on 100 consecutive in situ procedures and others with a commitment to in situ SLT suggest the effect on additional abdominal and thoracic organs is negligible (21) (27).…”

Section: Donor Selectionmentioning

confidence: 99%

“…In Europe, where cadaver organs are allocated to centers, rather than specific patients, increased flexibility is available for recipient selection and coordination (71). The result has been standing agreements between centers for sharing of partial grafts that have been quite successful (31,72). The past UNOS policy permitting the unrestricted use of remnant grafts by the SLT center was a direct incentive for the application of SLT; however, in regions where multiple centers are competing for each donor, rigid allocation policies impede SLT application.…”

Section: Obstacles Impeding Further Utilization Of Sltmentioning

confidence: 99%

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Split-Liver Transplantation: A Review

Renz

Yersiz

Reichert

et al. 2003

American Journal of Transplantation

104

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Split-liver transplantation (SLT), a procedure where one cadaver liver is divided to provide for two recipients, offers immediate expansion of the existing cadaver donor pool. To date, the principal beneficiaries of SLT have been adult/pediatric recipient pairs with excellent outcomes reported; however, the current scarcity of cadaver organs has renewed interest in expanding these techniques to include two adult recipients from one adult cadaver donor. Significant obstacles to the widespread application of SLT exist and must be resolved by the transplant community before greater utilization can be realized. This manuscript reviews the historic background, surgical techniques, current results, and obstacles impeding further application of SLT.

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Section: Donor Selectionmentioning

confidence: 99%

Section: Obstacles Impeding Further Utilization Of Sltmentioning

confidence: 99%

Split-Liver Transplantation: A Review

Renz

Yersiz

Reichert

et al. 2003

American Journal of Transplantation

104

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“…On the other hand, the prolonged dissection required to prepare the grafts before aortic cross clamp may be associated with increased blood loss and volume replacement and has prompted concerns from cardiac-thoracic teams that the quality of hearts and lungs may be affected. 28 Data from centers with a commitment to in situ SLT suggest the impact of the procedure is minimal, 29 though some anecdotal experiences indicate that prolonged dissection may impact other organs.…”

Section: Logisticsmentioning

confidence: 99%

Optimizing the use of donated cadaver livers: Analysis and policy development to increase the application of split-liver transplantation

Emond¹,

Freeman²,

Renz³

et al. 2002

Liver Transplantation

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“…This high amount of surgical blood loss can be explained not only by the fact of the donor facial dissection was performed under cardiac arrest, but also because of the great complexity of the recipient surgery, as described in the third case in the world which required 35 PRBC (3,4). In addition, the increased blood loss and volume replacement during organ recovery could prompt concerns that the quality of thoracic organs may be affected, as has occurred in other types of transplant (10). In our case, despite this there was a significant amount of blood requirement that did not affect the outcome of the other organs.…”

Section: Discussionmentioning

confidence: 99%

Logistics and Strategy of Multiorgan Procurement Involving Total Face Allograft

Bueno

Barret

Serracanta

et al. 2011

American Journal of Transplantation

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The face is the latest body structure to be added to the field of transplantation and the learning curve is ongoing. In the scenario of multiorgan recovery, the face is a nonvital 'organ' structure compared with other life-saving organs. To date, the face has been the first 'organ' to be procured in a multiorgan procurement. A technique for simultaneous recovery of the whole face, heart, lungs, liver, pancreas and kidneys is described. Thirty professionals participated in the procedure, of whom 13 were surgeons. No tracheotomy was performed. A mask of the donor's face was made from a mold impression. Duration of the procedure from skin incision to the end of surgery was 7.3 h. The face was perfused with Wisconsin solution through a cannula inserted into the aortic arch between the origin of the brachiocephalic arterial trunk and the left subclavian artery. Blood requirements consisted of 4 units of packed red blood cells. After the procedure, the mask was placed on the donor's face. All recovered grafts functioned immediately. In summary, simultaneous multiorgan procurement including the whole face is feasible, effective and saves time without jeopardizing life-saving organs and without the need for tracheotomy.

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Logistic aspects and procedures in split liver transplantation

Cited by 9 publications

References 0 publications

Split-Liver Transplantation: A Review

Split-Liver Transplantation: A Review

Optimizing the use of donated cadaver livers: Analysis and policy development to increase the application of split-liver transplantation

Logistics and Strategy of Multiorgan Procurement Involving Total Face Allograft

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