2004
DOI: 10.1111/j.1600-6143.2004.00594.x
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Predicted Lifetimes for Adult and Pediatric Split Liver Versus Adult Whole Liver Transplant Recipients

Abstract: Split liver transplantation allows 2 recipients to receive transplants from one organ. Comparisons of predicted lifetimes for two alternatives (split liver for an adult and pediatric recipient vs. whole liver for an adult recipient) can help guide the use of donor livers. We analyzed mortality risk for 48 888 waitlisted candidates, 907 split and 21 913 whole deceased donor liver transplant recipients between January 1, 1995 and February 26, 2002. Cox regression models for pediatric and adult patients assessed … Show more

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Cited by 93 publications
(103 citation statements)
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“…This early graft failure will result in increased need for retransplantation which has dramatically increased cost compared to primary transplant procedures (21,22). Other high cost complications which occur with greater frequency with high-risk donors include biliary leaks in both DCD (23) and anatomic variant grafts (24), early aggressive recurrence of hepatitis C in older liver grafts (12) and higher incidence of kidney allograft failure among recipients of liver/kidney transplants from marginal donors (25).…”
Section: Cost Of Marginal Liver Donorsmentioning
confidence: 99%
“…This early graft failure will result in increased need for retransplantation which has dramatically increased cost compared to primary transplant procedures (21,22). Other high cost complications which occur with greater frequency with high-risk donors include biliary leaks in both DCD (23) and anatomic variant grafts (24), early aggressive recurrence of hepatitis C in older liver grafts (12) and higher incidence of kidney allograft failure among recipients of liver/kidney transplants from marginal donors (25).…”
Section: Cost Of Marginal Liver Donorsmentioning
confidence: 99%
“…The practice of splitting livers from deceased donors increases availability of deceased donor livers for young children. 45 These practices should eliminate the need for children to donate to their siblings in all but the rarest circumstances.…”
Section: Conditionmentioning
confidence: 99%
“…With adult WLT, every 93 transplants used 100 livers (seven livers were used for retransplantation). However, when the split procedure was used, 100 livers were enough for 152 successful transplants (76 livers were split and 24 whole livers were used for retransplantation)-leading to an aggregate of 48 extra years of life lived over patients still on the waitlist, as compared to whole liver recipients' aggregate of 40 extra years of life lived over waitlist patients (4). While Merion's study is the factual foundation for our inquiry, it should again be emphasized that there is considerable variation in results between transplant centers (3,5,6).…”
Section: Outcomes Associated With Sltmentioning
confidence: 99%
“…Further, it is not apparent that WLT satisfies Objective 1 either, because of disproportionate costs. For every 100 donor livers, adult recipients of whole livers will gain an aggregate 10 more life years than they would have had the organs been split (4). At the same time, pediatric patients who would have received transplants had the livers been split, will lose 18 years of life over the 2-year period (4).…”
Section: Applying These Principles and Objectives To Slt And Wltmentioning
confidence: 99%
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