Preliminary experience with split liver transplantation.
BACKGROUND
The purpose of split liver transplantation is to alleviate the organ shortage for patients with end-stage liver disease. The procedure, however, has not gained wide acceptance. This is related not only to the complexity of the procedure but also to poorer results and the complications reported to be associated with the technique.


METHODS
We report 12 split liver transplantation procedures, seven in children and five in adults. Selection criteria were the same as those for whole-size liver transplantation. Patient and graft survival as well as complications were analyzed. Results were analyzed by Wilcoxon life tables.


RESULTS
Patient and graft survival rates are 91.6 and 75 percent, respectively. One patient died at 2.5 months after transplantation because of lymphoproliferative disease. Another had acute vanishing bile duct syndrome and required retransplantation at 1.5 months. One patient had retransplantation because of hepatic artery thrombosis. Bile leaks occurred in two patients and hemothorax in one patient.


CONCLUSIONS
Our results indicate that split liver transplantation has become a more acceptable method of hepatic transplantation and should be encouraged. Several guidelines can enhance success rates.
Kalayoglu
M
M
Department of Surgery, University of Wisconsin School of Medicine, Madison, USA.
D'Alessandro
A M
AM
Knechtle
S J
SJ
Hoffmann
R M
RM
Pirsch
J D
JD
Judd
R H
RH
Armbrust
M
M
Spaith
E
E
Pilli
G
G
Young
C J
CJ
Geffner
S R
SR
Odorico
J S
JS
Sollinger
H W
HW
Belzer
F O
FO
D000328:Adult; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D015993:Life Tables; D008107:Liver Diseases / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality / Q000502:physiology; D008297:Male; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D015996:Survival Rate; D014019:Tissue Donors / Q000600:supply & distribution