Surgical Training and Simulation of Split‐Liver Transplantation in an Ex Vivo Porcine Model

Sanada, Yukihiro; Hishikawa, Shuji; Katano, Takumi; Hirata, Yuta; Yamada, Naoya; Okada, Noriki; Mizuta, Koichi

doi:10.1002/lt.25391

Cited by 6 publications

(3 citation statements)

References 4 publications

(5 reference statements)

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“…Future directions could address the possibility that TVG utilization is due to lack of surgical expertise by development of training seminars, coursework, simulation models, cooperative arrangements, or consolidation of pediatric LT programs and each method to address has been described for other complex surgical procedures previously 25‐27 . The American Society of Transplant Surgeons has recently created and implemented several hands on training programs to increase expertise and application of LD nephrectomy and donation after cardiac death, which are examples of two other technically complex surgical transplant techniques for which centers have demonstrated variable utilization.…”

Section: Discussionmentioning

confidence: 99%

An appraisal of technical variant grafts compared to whole liver grafts in pediatric liver transplant recipients: Multicenter analysis from the SPLIT registry

McElroy

Martin

Feldman

et al. 2022

Pediatric Transplantation

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Background Shortages of liver allografts for children awaiting transplantation have led to high LT waitlist mortality. Prior studies have shown that usage of TVG can reduce waiting time and waitlist mortality, but their use is not universal. We sought to compare patient and graft survival between WLG and TVG and to identify potential associated risk factors in a contemporary pediatric LT cohort. Methods We performed a retrospective analysis of patient survival, graft survival, and biliary and vascular complications for LT recipients <18 years old entered into the Society of Pediatric Liver Transplantation prospective multicenter database. Results Of 1839 LT recipients, 1029 received a WLG and 810 received a TVG from either a LD or a DD. There was no difference in patient survival or graft survival by graft type. Three‐year patient survival and graft survival were 96%, 93%, and 96%, and 95%, 89%, and 92% for TVG‐LD, TVG‐DD, and WLG, respectively. Biliary complications were more frequent in TVG. Hepatic artery thrombosis was more frequent in WLG. Multivariate analysis revealed primary diagnosis was the only significant predictor of patient survival. Predictors for graft survival included time‐dependent development of biliary and vascular complications. Conclusions There were no significant differences in patient and graft survival based on graft types in this North American multi‐center pediatric cohort. Widespread routine use of TVG should be strongly encouraged to decrease mortality on the waitlist for pediatric LT candidates.

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Section: Discussionmentioning

confidence: 99%

An appraisal of technical variant grafts compared to whole liver grafts in pediatric liver transplant recipients: Multicenter analysis from the SPLIT registry

McElroy

Martin

Feldman

et al. 2022

Pediatric Transplantation

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“…Sanada et al described the use of an inanimate ex vivo porcine model to train surgical residents on the key components of organ preparation for split liver transplantation—an extended right lobectomy and left lateral segmentectomy [ 23 ]. The authors describe porcine hepatic vascular and intra-hepatic biliary anatomy as analogous to human hepatic anatomy and provide additional detail regarding the appropriate plane of transection based upon external porcine landmarks.…”

Section: Resultsmentioning

confidence: 99%

Technical skills simulation in transplant surgery: a systematic review

Patnaik

Khan

et al. 2022

Global Surg Educ

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Purpose Transplant surgery is a demanding field in which the technical skills of the surgeon correlates with patient outcomes. As such, there is potential for simulation-based training to play an important role in technical skill acquisition. This study provides a systematic assessment of the current literature regarding the use of simulation to improve surgeon technical skills in transplantation. Methods Data were collected by performing an electronic search of the PubMed and Scopus database for articles describing simulation in transplant surgery. The abstracts were screened using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Three reviewers analyzed 172 abstracts and agreed upon articles that met the inclusion criteria for the systematic review. Results Simulators can be categorized into virtual reality simulators, cadaveric models, animal models (animate or inanimate) and synthetic physical models. No virtual reality simulators in transplant surgery are described in the literature. Three cadaveric models, seven animal models and eight synthetic physical models specific to transplant surgery are described. A total of 18 publications focusing on technical skills simulation in kidney, liver, lung, pancreas, and cardiac transplantation were found with the majority focusing on kidney transplantation. Conclusions This systematic review identifies currently reported simulation models in transplant surgery. This will serve as a reference for general surgery and transplant surgery professionals interested in using simulation to enhance their technical skills.

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“…In this issue of Liver Transplantation , Sanada et al describe the use of an ex vivo porcine liver model to train surgeons to split a cadaveric liver. They describe some general variations in the lobar anatomy of the porcine liver compared with the human liver, which must, of course, be taken into consideration in the training process.…”

mentioning

confidence: 99%

Animal Model Simulation for Training With Split‐Liver Transplants

Fryer¹

2019

Liver Transpl

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Surgical Training and Simulation of Split‐Liver Transplantation in an Ex Vivo Porcine Model

Abstract: referenCes 1) Hsu EK, Mazariegos GV. Global lessons in graft type and pediatric liver allocation: a path toward improving outcomes and eliminating wait-list mortality. Liver Transpl 2017;23:86-95.

Cited by 6 publications

References 4 publications

An appraisal of technical variant grafts compared to whole liver grafts in pediatric liver transplant recipients: Multicenter analysis from the SPLIT registry

An appraisal of technical variant grafts compared to whole liver grafts in pediatric liver transplant recipients: Multicenter analysis from the SPLIT registry

Technical skills simulation in transplant surgery: a systematic review

Animal Model Simulation for Training With Split‐Liver Transplants

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