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Related Experiment Videos

Split liver transplantation.

R W Busuttil1, J A Goss

  • 1Department of Surgery, The Dumont-UCLA Transplant Center, University of California, Los Angeles School of Medicine, 90095-7054, USA.

Annals of Surgery
|March 17, 1999
PubMed
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Split liver transplantation, using ex vivo or in situ methods, expands donor organs for liver transplants. In situ splitting offers superior graft and patient survival rates compared to ex vivo techniques.

Area of Science:

  • Hepatology
  • Transplant Surgery
  • Organ Donation

Background:

  • Cadaveric donor liver shortage limits transplantation for end-stage liver disease.
  • Pediatric recipients face the greatest challenge due to scarcity of size-matched organs.
  • Split liver transplantation (SLT) is a viable strategy to increase organ availability for both pediatric and adult recipients.

Purpose of the Study:

  • To review the indications, technical aspects, and outcomes of ex vivo and in situ split liver transplantation.
  • To compare and contrast the two primary techniques of SLT.
  • To evaluate SLT's role in expanding the donor liver pool.

Main Methods:

  • Review of evolution from reduced and living-related liver transplantation to split liver transplantation.

Related Experiment Videos

  • Comparison of ex vivo and in situ splitting techniques, including patient selection and current results.
  • Analysis of graft division, cold ischemia times, and benching procedures.

    • Main Results:

    • Ex vivo SLT involves bench splitting, typically creating two grafts; historically, it showed lower survival and higher complication rates than whole organ transplants.
    • In situ SLT, performed similarly to living donor procurement, yields comparable graft types but demonstrates superior outcomes.
    • In situ split liver grafts achieve over 85% graft and 90% patient survival, with fewer postoperative complications, even in urgent cases.

    Conclusions:

    • Split cadaveric liver transplantation effectively expands the organ donor pool, potentially reducing the need for living donation in children.
    • While ex vivo SLT can yield comparable survival to whole organ transplants in elective adult cases, complication rates remain higher.
    • In situ SLT provides high-quality grafts suitable for all transplant recipients and is the preferred method for increasing the cadaver liver donor supply.