Split-liver transplantation allows 2 allografts from a single cadaveric donor liver.
Researchers from Los Angeles, California, identified the predictors of graft and recipient survival for in situ split-liver transplantations. They also compared these outcomes to those from living donor and whole organ transplantations.
The team conducted a retrospective analysis of 100 consecutive in situ split-liver transplantations, which were performed at the University of California between 1991 and 2003.
Each liver yielded a left lateral segment and right trisegment graft, and 190 allografts were available for transplantation.
|Long-term graft function was excellent.|
|Annals of Surgery|
The transplant recipients included 105 children and 60 adults.
The team compared outcomes and complications with living donor and whole organ recipients who underwent transplantation during the same period.
The doctors found there was no difference in the incidence of biliary and vascular complications in left lateral segment recipients, compared with left lateral segments from living donors. There was also no difference between these patients and children receiving whole-organ grafts from pediatric donors.
The team did not find any differences in left lateral segment graft and recipient survival between split-liver, living donor, and whole-organ recipients.
However, with the right trisegment split-liver grafts there was a 10% incidence of biliary complications and a 7% incidence of vascular complications.
Overall, the researchers determined that long-term graft function was excellent. Patient and graft survival was equal to that of whole-organ recipients, from donors aged 10 to 40 years.
The team identified several predictors of graft and recipient survival. These included United Network for Organ Sharing status at transplantation, indication, complication occurrence, donor creatinine, and length of donor hospitalization.
Dr Hasan Yersiz's "Split-liver transplantation is an effective mechanism for immediate expansion of the cadaver donor pool that can reduce dependence upon living donation".