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Split liver transplantation for hepatocellular carcinoma.
Georgios C Sotiropoulos1, Hauke Lang, Nils R Frühauf
1Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Germany.
Hepato-Gastroenterology
|November 8, 2006
Summary
Deceased donor split liver transplantation (LTx) offers a viable option for patients with hepatocellular carcinoma (HCC) and cirrhosis awaiting a full-size liver. This approach can benefit patients unlikely to survive the waiting period.
Area of Science:
- Hepatobiliary Surgery
- Transplant Immunology
- Gastroenterology
Background:
- Liver transplantation (LTx) is the primary treatment for small hepatocellular carcinoma (HCC) in patients with end-stage liver failure.
- Limited organ availability restricts access to full-size liver allografts for many eligible patients.
Purpose of the Study:
- To evaluate the feasibility and outcomes of using deceased donor split liver allografts.
- To assess the safety and efficacy of split liver transplantation in patients with HCC and cirrhosis.
Main Methods:
- A 28-month study involving 6 deceased donor split liver allografts transplanted into stable recipients with HCC and cirrhosis.
- Utilized extended right split grafts (segments I, IV-VIII) and right split grafts.
- Included both in situ and ex situ graft harvesting procedures.
Main Results:
- 5 men and 1 woman (median age 60 years) received transplants with a median waiting time of 82 days.
- No primary non-function observed; median intensive care unit stay was 4 days.
- 5 of 6 patients survived with a median follow-up of 20 months; 2 re-operations for abscesses occurred, and 1 patient died from unrelated causes.
Conclusions:
- Deceased donor split LTx is a valuable alternative for HCC patients with cirrhosis on the waiting list.
- Careful individual evaluation of risks and benefits is crucial for split liver transplantation.
- This technique expands the donor pool and offers a chance for survival to critically ill patients.
