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Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
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Split liver transplantation.

D C Broering1, J Schulte am Esch, L Fischer

  • 1Department of Hepatobiliary Surgery and Transplantation, University of Hamburg, Germany.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
|March 12, 2008
PubMed
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Split liver transplantation increases organ availability, reducing waitlist deaths for children. Two main techniques offer comparable results to whole organ transplants for both pediatric and adult recipients.

Area of Science:

  • Hepatobiliary Surgery
  • Transplantation Medicine

Background:

  • Split liver transplantation is a strategy to increase cadaveric liver graft availability.
  • It has significantly reduced pediatric liver transplant waitlist mortality over the past decade.

Purpose of the Study:

  • To review the anatomical and technical aspects of liver splitting.
  • To summarize the clinical experience of two primary split liver transplantation approaches.

Main Methods:

  • Review of two main liver splitting techniques: left lateral/right extended grafts and full right/full left hemi-grafts.
  • Analysis of outcomes for pediatric and adult recipients based on graft type.

Main Results:

  • Left lateral/right extended splitting yields results comparable to whole organ transplantation for both pediatric and adult recipients.

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  • Full right/full left splitting expands the adult liver graft pool but requires advanced surgical expertise and knowledge of anatomical variations.

    • Conclusions:

    • Split liver transplantation is effective in increasing graft availability and improving outcomes for pediatric and adult patients.
    • Centers performing split liver transplantation for two adults should have high transplant volumes and expertise in hepatobiliary surgery.