Latest development in split liver transplantation.
Currently, orthotopic liver transplantation (LT) represents the treatment of choice for most end-stage liver diseases. Advances in surgical techniques and immunosuppressive therapy have markedly increased its success. However, the main obstacle in LT remains the lack of donor organs with a current mortality rate for patients on the waiting list of up to 20%. This chapter focuses on developments in SLT techniques and living-donor LT to alleviate this problem. SLT yields a net gain of organs, in that it uses one organ to save either an adult and a child, or two adults. The initially used technique of ex-situ splitting is being replaced progressively by the in-situ splitting technique, which yields better preserved grafts. The latest step has been the introduction of living-donor segmental LT. The systematic combination of both techniques may lead to a further reduction of mortality for patients on the waiting list for LT.
Frühauf
Nils R
NR
Department of General Surgery and Transplantation, University Essen, Essen, Germany.
Malagó
Massimo
M
Frilling
Andrea
A
Beckebaum
Susanne
S
Broelsch
Christoph E
CE
D005260:Female; D005544:Forecasting; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008099:Liver / Q000601:surgery*; D017093:Liver Failure / Q000175:diagnosis / Q000601:surgery*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality / Q000639:trends; D008297:Male; D019990:Perioperative Care; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000592:standards* / Q000639:trends; D014850:Waiting Lists