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 |
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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 |
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)