Split-liver transplantation with pediatric donors: a multicenter experience

Area of Science:

• Hepatology
• Transplantation Surgery
• Pediatric Surgery

Background:

• Outcomes of split-liver transplantation (SLT) utilizing pediatric donors remain largely unreported.
• Pediatric donors represent a potential source for liver grafts, but their utilization in SLT requires specific investigation.

Purpose of the Study:

• To evaluate the outcomes of split-liver transplantation (SLT) using donors younger than 15 years.
• To compare graft and patient survival rates between different donor age groups and graft types (left lateral segment and extended right graft).

Main Methods:

• A prospective multicenter study involving 39 split-liver procedures from donors under 15 years old.
• Analysis of 67 grafts (38 left lateral segments and 29 extended right grafts) transplanted into pediatric and adult recipients.
• Data collection on patient and graft survival, and complications, with a median follow-up of 24 months.

Main Results:

• Two-year patient and graft survival rates were 87% and 82%, respectively.
• No significant differences in survival were observed between pediatric and adult recipients, or between grafts from donors aged ≤10 years versus 11-15 years.
• Arterial complications occurred in 6% of cases, with similar incidence across donor age and graft types.

Conclusions:

• Split-liver transplantation using pediatric donors, including those younger than 10 years, achieves results comparable to those with adult donors.
• The findings suggest that maintaining the celiac trunk with the left lateral segment graft does not negatively impact right-sided grafts.