Split or whole liver transplantation? Utilization and posttransplant survival

Area of Science:

• Hepatology
• Transplantation Surgery
• Organ Donation

Background:

• Split liver transplantation (SLT) divides one donor liver for two recipients, potentially increasing organ supply.
• SLT can provide size-matched livers for pediatric candidates and more organs for adults.
• Despite its potential, SLT use has plateaued due to survival concerns compared to whole liver transplantation (WLT).

Purpose of the Study:

• To compare posttransplant survival between SLT and WLT recipients.
• To analyze donor-recipient characteristics and match dynamics in SLT versus WLT.
• To address limitations in prior survival analyses of SLT.

Main Methods:

• Utilized the Organ Procurement and Transplantation Network database (2003-2019).
• Compared donor/recipient characteristics, organ offer/acceptance dynamics, and posttransplant survival for SLT and WLT.
• Controlled for confounding factors in survival analysis.

Main Results:

• Posttransplant survival rates for SLT and WLT recipients were found to be similar.
• Analysis controlled for confounding factors impacting survival outcomes.
• Donor-recipient match dynamics and characteristics were also compared.

Conclusions:

• SLT demonstrates comparable survival to WLT, validating its use.
• SLT is crucial for expanding the liver donor organ supply.
• This technique offers significant potential benefits for both pediatric and adult liver transplant candidates.