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Related Experiment Videos

Split-liver full-left full-right: proposal for an operative protocol.

F Ferla1, A Lauterio1, S Di Sandro1

  • 1Chirurgia Generale e dei Trapianti, Ospedale Niguarda, Milano, Italy.

Transplantation Proceedings
|September 23, 2014
PubMed
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This study outlines a protocol for splitting deceased donor livers into two grafts for adult recipients, addressing organ shortage. The proposed criteria aim to increase the feasibility and safety of liver transplantation using split grafts.

Area of Science:

  • Hepatology
  • Transplantation Surgery
  • Organ Procurement

Background:

  • Organ shortage is a critical barrier to liver transplantation worldwide.
  • Splitting deceased donor livers into two hemilivers offers a strategy to increase graft availability for adult recipients.

Purpose of the Study:

  • To describe an adult-to-adult split liver operative protocol.
  • To facilitate the sharing of this protocol among interested transplant centers.

Main Methods:

  • Literature review to establish the operative protocol.
  • Identification of strict selection criteria for deceased donors and recipients.
  • Analysis of technical aspects for graft procurement and transplantation.

Main Results:

Related Experiment Videos

  • Specific donor criteria include age ≤55 years, weight ≥70 kg, BMI <28 kg/m², limited ICU stay, and absence of significant steatosis or viral infections.
  • Recipient exclusion criteria include UNOS status 1/2A and transjugular intrahepatic portosystemic shunts.
  • Graft selection requires a graft-to-recipient weight ratio ≥1% and spleen size ratio ≥0.6.

Conclusions:

  • The developed protocol provides a framework for evaluating the feasibility of full-left/full-right split liver procedures.
  • A retrospective analysis identified 130 suitable transplantations from 65 donors under these criteria.
  • Wider adoption of this protocol could significantly increase the utilization of split liver grafts.