Abstract
Full-right-full-left split liver transplantation divides a donor liver into two grafts to be transplanted in adult-size patients. Major technical and organizational difficulties have limited its application to few single center series. We retrospectively analyzed the long-term results of the first multicenter series of this procedure with graft sharing. Between November 1998 and January 2005, 43 transplants were performed by five centers from 23 full-right-full-left in situ split liver procedures; 65% of the grafts were shared. A total of 31 (72%) patients had complications above grade II; 3 (6.9%) were retransplanted. Hospital mortality was 23% with sepsis as the main cause. Six patients died in the long term, two of them for a road accident. A total of 27 patients are alive after a median follow-up of 3200 days (2035-4256). Actuarial survival at 1 and 10 years were 72.1%, 62.6% and 65.1%, 57.9%, respectively for patients and grafts. These figures are similar to those reported for adult living donor liver transplantation by the European Registry over a similar period. Multicenter collaboration in sharing of these grafts is feasible and can help facing the organizational limits, thus increasing diffusion of full-right-full-left split liver transplantation. Full right and full left grafts from split liver procedures can be shared among different centers of the same area in the context of a collaborative activity, being safely and effectively transplanted in adult patients, thus optimizing the use of deceased donor livers.
| Original language | English |
|---|---|
| Pages (from-to) | 2198-2210 |
| Number of pages | 13 |
| Journal | American Journal of Transplantation |
| Volume | 12 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Aug 2012 |
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Keywords
- adult to adult
- Adults
- full-right-full-left graft
- graft sharing
- partial graft
- Split liver
- splitting technique
ASJC Scopus subject areas
- Transplantation
- Immunology and Allergy
- Pharmacology (medical)
Cite this
Full-right-full-left split liver transplantation : The retrospective analysis of an early multicenter experience including graft sharing. / Zambelli, M.; Andorno, E.; De Carlis, L.; Rossi, G.; Cillo, U.; De Feo, T.; Carobbio, A.; Giacomoni, A.; Bottino, G.; Colledan, M.
In: American Journal of Transplantation, Vol. 12, No. 8, 08.2012, p. 2198-2210.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Full-right-full-left split liver transplantation
T2 - The retrospective analysis of an early multicenter experience including graft sharing
AU - Zambelli, M.
AU - Andorno, E.
AU - De Carlis, L.
AU - Rossi, G.
AU - Cillo, U.
AU - De Feo, T.
AU - Carobbio, A.
AU - Giacomoni, A.
AU - Bottino, G.
AU - Colledan, M.
PY - 2012/8
Y1 - 2012/8
N2 - Full-right-full-left split liver transplantation divides a donor liver into two grafts to be transplanted in adult-size patients. Major technical and organizational difficulties have limited its application to few single center series. We retrospectively analyzed the long-term results of the first multicenter series of this procedure with graft sharing. Between November 1998 and January 2005, 43 transplants were performed by five centers from 23 full-right-full-left in situ split liver procedures; 65% of the grafts were shared. A total of 31 (72%) patients had complications above grade II; 3 (6.9%) were retransplanted. Hospital mortality was 23% with sepsis as the main cause. Six patients died in the long term, two of them for a road accident. A total of 27 patients are alive after a median follow-up of 3200 days (2035-4256). Actuarial survival at 1 and 10 years were 72.1%, 62.6% and 65.1%, 57.9%, respectively for patients and grafts. These figures are similar to those reported for adult living donor liver transplantation by the European Registry over a similar period. Multicenter collaboration in sharing of these grafts is feasible and can help facing the organizational limits, thus increasing diffusion of full-right-full-left split liver transplantation. Full right and full left grafts from split liver procedures can be shared among different centers of the same area in the context of a collaborative activity, being safely and effectively transplanted in adult patients, thus optimizing the use of deceased donor livers.
AB - Full-right-full-left split liver transplantation divides a donor liver into two grafts to be transplanted in adult-size patients. Major technical and organizational difficulties have limited its application to few single center series. We retrospectively analyzed the long-term results of the first multicenter series of this procedure with graft sharing. Between November 1998 and January 2005, 43 transplants were performed by five centers from 23 full-right-full-left in situ split liver procedures; 65% of the grafts were shared. A total of 31 (72%) patients had complications above grade II; 3 (6.9%) were retransplanted. Hospital mortality was 23% with sepsis as the main cause. Six patients died in the long term, two of them for a road accident. A total of 27 patients are alive after a median follow-up of 3200 days (2035-4256). Actuarial survival at 1 and 10 years were 72.1%, 62.6% and 65.1%, 57.9%, respectively for patients and grafts. These figures are similar to those reported for adult living donor liver transplantation by the European Registry over a similar period. Multicenter collaboration in sharing of these grafts is feasible and can help facing the organizational limits, thus increasing diffusion of full-right-full-left split liver transplantation. Full right and full left grafts from split liver procedures can be shared among different centers of the same area in the context of a collaborative activity, being safely and effectively transplanted in adult patients, thus optimizing the use of deceased donor livers.
KW - adult to adult
KW - Adults
KW - full-right-full-left graft
KW - graft sharing
KW - partial graft
KW - Split liver
KW - splitting technique
UR - http://www.scopus.com/inward/record.url?scp=84864449926&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84864449926&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2012.04071.x
DO - 10.1111/j.1600-6143.2012.04071.x
M3 - Article
VL - 12
SP - 2198
EP - 2210
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 8
ER -