Long-term Outcome of Split Liver Transplantation Using Right Extended Grafts in Adulthood

Wilms, Christian; Walter, Jessica; Kaptein, Maren; Müeller, Lars; Lenk, Christian; Sterneck, Martina; Hillert, C.; Fischer, Lutz; Rogiers, Xavier; Bröering, Dieter C.

doi:10.1097/01.sla.0000247254.76747.f3

Cited by 92 publications

(81 citation statements)

References 23 publications

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“…The Hamburg group recently reported that transplantation of the right extended lobe deriving from left lateral splitting of deceased donor livers is followed by the same long-term patient and graft survival, which is known from full size LTx. There were no differences in the complication rates even in long-term outcome [85]. Although the progress of SLT, the complexity of the whole procedure allows for a series of complications which might occur postoperatively, including bleeding, bile leakage, and infection of the transected liver surface; disparity of graft size, complications of the hepatic artery and the bile duct caused by complex reconstructions, and outflow problems related to the hepatic veins.…”

Section: Split Liver Transplantationmentioning

confidence: 91%

Partial liver transplantation-living donor liver transplantation and split liver transplantation

Müller

Mehrabi

Schmied

et al. 2007

Nephrology Dialysis Transplantation

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In the last two decades, liver transplantation (LTx) has become the treatment of choice for several liver diseases including hepatocellular carcinoma in selected cases. Improvements in surgical and anesthesiological procedures have increased patient survival after LTx, resulting in excellent 1-year survival rates. The ratelimiting factor to further increase the number of LTx is the extreme shortage of suitable organs with the consequence that pediatric and adult patients are dying on the waiting list. At present, mortality reported for pediatric and adult patients on the waiting list is 10 to 20%. Living-donor liver transplantation and split liver transplantation are measurements to reduce the severe lack of cadaveric grafts by expanding the donor pool. Major centers around the world now routinely perform partial LTx in infants and adults with survival success equivalent to that after full-size liver transplantation.

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Section: Split Liver Transplantationmentioning

confidence: 91%

Partial liver transplantation-living donor liver transplantation and split liver transplantation

Müller

Mehrabi

Schmied

et al. 2007

Nephrology Dialysis Transplantation

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“…Surveys in Western populations indicate that SLT in adults is associated with significant increase (about 10%) in graft failure and recipient morbidity. 8,33,[97][98][99] Results are notably better in children. 100 Even if split liver grafts are procured from young donors with normal parenchyma and short CIT, they should be considered extended criteria grafts for the following reasons: (a) the graft volume is generally lower than the recipient's standard liver volume and may be insufficient to adequately meet the metabolic demand during the early postoperative course.…”

Section: Split Liver Graftsmentioning

confidence: 84%

Changing Pattern of Donor Selection Criteria in Deceased Donor Liver Transplant: A Review of Literature

Routh

Naidu

Sharma

et al. 2013

Journal of Clinical and Experimental Hepatology

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During the last couple of decades, with standardization and progress in surgical techniques, immunosuppression and post liver transplantation patient care, the outcome of liver transplantation has been optimized. However, the principal limitation of transplantation remains access to an allograft. The number of patients who could derive benefit from liver transplantation markedly exceeds the number of available deceased donors. The large gap between the growing list of patients waiting for liver transplantation and the scarcity of donor organs has fueled efforts to maximize existing donor pool and identify new avenues. This article reviews the changing pattern of donor for liver transplantation using grafts from extended criteria donors (elderly donors, steatotic donors, donors with malignancies, donors with viral hepatitis), donation after cardiac death, use of partial grafts (split liver grafts) and other suboptimal donors (hypernatremia, infections, hypotension and inotropic support). ( J CLIN EXP HEPATOL 2013;3:337-346)

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“…A recent match pair analysis of patients after whole versus split liver transplantation using an extended right liver lobe found no difference in neither short nor long-term morbidity or mortality [57]. Others, however, showed an inferior graft survival rate for recipients of the left graft [58].…”

Section: Type Of Graftmentioning

confidence: 97%

Hot topics in liver transplantation: Organ allocation – extended criteria donor – living donor liver transplantation

Müllhaupt¹,

Dimitroulis²,

Gerlach³

et al. 2008

Journal of Hepatology

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Liver transplantation has become the mainstay for the treatment of end-stage liver disease, hepatocellular cancer and some metabolic disorders. Its main drawback, though, is the disparity between the number of donors and the patients needing a liver graft. In this review we will discuss the recent changes regarding organ allocation, extended donor criteria, living donor liver transplantation and potential room for improvement. The gap between the number of donors and patients needing a liver graft forced the transplant community to introduce an objective model such as the modified model for end-stage liver disease (MELD) in order to obtain a transparent and fair organ allocation system. The use of extended criteria donor livers such as organs from older donors or steatotic grafts is one possibility to reduce the gap between patients on the waiting list and available donors. Finally, living donor liver transplantation has become a standard procedure in specialized centers as another possibility to reduce the donor shortage. Recent data clearly indicate that center experience is of major importance in achieving good results. Great progress has been made in recent years. However, further research is needed to improve results in the future.

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Long-term Outcome of Split Liver Transplantation Using Right Extended Grafts in Adulthood

Cited by 92 publications

References 23 publications

Partial liver transplantation-living donor liver transplantation and split liver transplantation

Partial liver transplantation-living donor liver transplantation and split liver transplantation

Changing Pattern of Donor Selection Criteria in Deceased Donor Liver Transplant: A Review of Literature

Hot topics in liver transplantation: Organ allocation – extended criteria donor – living donor liver transplantation

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