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 19 February 2018

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News

A national survey of split-liver transplantation in the United States

Biliary and vascular complications account for the majority of morbidity in split-liver transplantations, find researchers in the February issue of Annals of Surgery.

News image

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Split-liver transplantation is a theoretically attractive mechanism to increase cadaver organ supply. In this study, a team of researchers assessed the application and outcomes of split-liver transplantation in the United States.

They surveyed 89 surgical teams between 2000 and 2001. The researchers collected data on graft type, recipient status, procurement method, graft sharing, graft outcomes, recipient outcomes, and experience with whole-organ transplantation.

Of the 89 surgical teams, 83 provided the researchers with data on 207 left lateral segment, 152 right trisegment, 15 left lobe, and 13 right lobe grafts.
Primary nonfunction, graft failure, and recipient death correlated with transplant status.
Annals of Surgery

The research team established that the split procedure was performed ex vivo in 54% and in situ in 46% of grafts.

They determined that complications occurred frequently in all graft types. Biliary and vascular complications were evenly distributed between grafts procured by either technique.

The researchers found that primary nonfunction, graft failure, and recipient death correlated with transplant status.

Dr John Renz's team concluded, "Split-liver transplantation has been principally applied to adult-child pairs with at least one recipient critically ill".

"Biliary and vascular complications account for the majority of morbidity in grafts procured by either split technique with graft failure and recipient death observed more frequently in critically ill recipients".

"Enhanced utilization and improved results may be possible through improved information sharing and modification of allocation criteria".

Ann Surg 2004; 239(2): 172-81
26 January 2004

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