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

E Nesher1, E Island, P Tryphonopoulos

  • 1Division of Transplantation, Department of Surgery, University of Miami School of Medicine, Miami, Florida 33136, USA. eviatar.nesher@gmail.com

Transplantation Proceedings
|June 23, 2011
PubMed
Summary
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Split liver transplantation offers a viable solution for expanding the donor pool, significantly reducing waitlist mortality for both adult and pediatric patients needing a liver transplant.

Area of Science:

  • Hepatology
  • Transplantation Surgery
  • Pediatric Surgery

Background:

  • Liver transplantation is a life-saving procedure for end-stage liver disease.
  • Organ donor shortages present a significant challenge in meeting the demand for liver transplants.
  • Split liver transplantation utilizes one donor liver for two recipients, maximizing organ utilization.

Purpose of the Study:

  • To evaluate the outcomes of split liver transplantation in a mixed adult and pediatric cohort.
  • To assess patient and graft survival rates in split liver transplant recipients.
  • To determine the efficacy of split liver transplantation in expanding the donor pool and reducing waitlist mortality.

Main Methods:

  • Retrospective analysis of 55 patients (30 adults, 25 children) who underwent split liver transplantation between September 1996 and December 2008.

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  • Median follow-up duration of 12 years.
  • Analysis of patient and graft survival, retransplantation rates, and complications.

    • Main Results:

    • Overall patient survival was 71% (adult 70%, pediatric 72%) with a median follow-up of 12 years.
    • Mean patient survival was 61.58 months and mean graft survival was 44.35 months.
    • Twelve patients (21.8%) required retransplantation due to primary nonfunction, chronic rejection, or vascular complications.

    Conclusions:

    • Split liver transplantation is an effective strategy to increase the availability of donor livers for both adult and pediatric recipients.
    • This technique demonstrates favorable survival rates and can significantly mitigate waiting list mortality, particularly for patients with specific blood groups.
    • Split liver transplantation represents a valuable approach to optimize organ utilization in liver transplantation programs.