One liver for two adults: in situ split liver transplantation for two adult recipients

Andorno, Enzo; Genzone, A; Morelli, N; Mondello, R; Colledan, M.; Gridelli, Bruno; Ravazzoni, Ferruccio; Giannelli, A; Rossi, G.; Ardizzone, G; Bottino, G; Valente, Umberto

doi:10.1016/s0041-1345(00)02536-7

Cited by 27 publications

(13 citation statements)

References 10 publications

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“…Since the first full‐left full‐right splitting procedures in the 1990s, it remains a procedure performed only in rare occasions. Published data are sparse including small series of cases performed in a limited number of experienced centers . Available data focus on the operative procedure or the early postoperative period.…”

Section: Introductionmentioning

confidence: 99%

“…Published data are sparse including small series of cases performed in a limited number of experienced centers. [3][4][5][6][7][8][9][10][11][12][13] Available data focus on the operative procedure or the early postoperative period. Our aim was to perform a longterm follow-up (up to 10-15 years after LTX) of our patients receiving a full-split graft divided into adult and pediatric recipients and full-left vs full-right grafts.…”

Section: Introductionmentioning

confidence: 99%

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Long‐term follow‐up after full‐split liver transplantation and its applicability in the recent transplant era

Herden

Fischer

Sterneck

et al. 2018

Clinical Transplantation

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long‐term follow‐up after full‐split liver transplantation and its applicability in the recent transplant era

Herden

Fischer

Sterneck

et al. 2018

Clinical Transplantation

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“…Following the early experiences of the 1980s,5, 6 a SLT program has been implemented also in the NITp area7 since 1997 using the conventional splitting procedure, which assigns the left lateral segment (LLS) of the donated liver to pediatric recipients and the right trisegment liver (RTL) to adults. More recently, a modified split liver (MSL) technique based on the division of the donated liver in 2 similarly sized parts has also been implemented8, 9 to allow LT in 2 small adults.…”

mentioning

confidence: 99%

Split and whole liver transplantation outcomes: A comparative cohort study

et al. 2006

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A specific split liver transplantation (SLT) program has been pursued in the North Italian Transplant program (NITp) since November 1997. After 5 yr, 1,449 liver transplants were performed in 7 transplant centers, using 1,304 cadaveric donors. Whole liver transplantation (WLT) and SLT were performed in 1,126 and 323 cases, respectively. SLTs were performed in situ as 147 left lateral segments (LLS), 154 right trisegment liver (RTL) grafts, and 22 modified split livers (MSL), used for couples of adult recipients. After a median posttransplant follow-up of 22 months, SLTs achieved a 3-yr patient and graft survival not significantly different from the entire series of transplants (79.4 and 72.2% vs. 80.6 and 74.9%, respectively). Recipients receiving a WLT or a LLS showed significantly better outcomes than patients receiving RTL and MSL (P Ͻ 0.03 for patients and P Ͻ 0.04 for graft survival). At the multivariate analysis, donor age of Ͼ60 yr, RTL transplant, Ͻ50 annual transplants volume, urgent transplantation (United Network for Organ Sharing (UNOS) status I and IIA), ischemia time of Ͼ7 hours, and retransplantation were factors independently related to graft failure and to significantly worst patient survival. Right grafts procured from RTL and either split procured as MSL had a similar outcome of marginal whole livers. In conclusion, in 5 yr, the increased number of pediatric transplants due to split liver donation reduced to 3% the in-list children mortality, and a decrease in the adult patient dropout rate from 27.2 to 16.2% was observed. Such results justify a more widespread adoption of SLT protocols, organizational difficulties not being a limit for the application of such technique. Liver Transpl 12: 402-410, 2006.

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“…Successful SLT in two adults has also been reported . Humar et al observed good outcomes, with no PNF, in 10 of 12 adult in situ split‐liver recipients.…”

Section: Split‐liver Transplantationmentioning

confidence: 99%

The use of marginal grafts in liver transplantation

Hashimoto

Miller

2008

J Hepatobiliary Pancreat Surg

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Because of the shortage of organ supplies, more transplant programs have begun to use marginal grafts in liver transplantation. A number of single-center experiences with marginal grafts have yielded encouraging results, but recent analyses using nationwide databases show that outcomes are inferior to results with normal whole-liver grafts. Use of marginal grafts is still acceptable, however, and plays an important role in expanding the donor pool and decreasing mortality on the waiting list. In the broadest terms, national data and single-center experiences show that: (1) there is no limit in donor age for liver transplantation, (2) appropriate selection of steatotic livers improves outcomes, (3) prolonged graft ischemia is a preventable factor, (4) livers from donors with hepatitis B or C virus can be safely transplanted, and (5) adequate prophylaxis prevents recurrence of hepatitis B without significant graft loss. In addition, grafts procured after cardiac death are another growing source of marginal grafts. Transmission of malignancy from donors is rare but life-threatening. Reduced-size grafts from living-donor or split-liver transplantation have shown similar outcomes to whole-liver transplantation. In this review, we will discuss the current status of the utility of these marginal grafts in liver transplantation.

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One liver for two adults: in situ split liver transplantation for two adult recipients

Cited by 27 publications

References 10 publications

Long‐term follow‐up after full‐split liver transplantation and its applicability in the recent transplant era

Long‐term follow‐up after full‐split liver transplantation and its applicability in the recent transplant era

Split and whole liver transplantation outcomes: A comparative cohort study

The use of marginal grafts in liver transplantation

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