title: Split-liver transplantation with pediatric donors: a multicenter experience.
abstract: BACKGROUND
  Outcomes of split-liver transplantation (SLT) with pediatric donors have never been specifically reported.
  
  
  METHODS
  A prospective multicenter study on SLT using donors younger than 15 years was conducted. Thirty-nine split-liver procedures generating a left lateral segment (LLS) and an extended right graft (ERG) were performed. In three cases, no recipient was found for ERG. In all but one case, the celiac trunk was maintained with LLS. Data were available for 67 grafts (90% of the total): 38 LLSs and 9 ERGs transplanted into 46 children and 20 ERGs transplanted into 20 adults. Sixty-two (93%) grafts were used for primary transplants and five (7%) for retransplantation. SLT were performed with 15 donors 10 years of age and less and with 24 between 11 and 15 years.
  
  
  RESULTS
  Median follow-up was 24 months. Two-year patient and graft survival were 87% and 82%. Patient and graft survivals were not significantly different between pediatric and adult recipients, between recipients from donors 10 years of age and less and those between 11 and 15 years, and between recipients of LLS and ERG. Arterial complications occurred in 6% of cases (8% in the < or = 10 year donors group, 5% in the 11-15 year donors group). The incidence of other complications was similar between groups.
  
  
  CONCLUSIONS
  SLT with pediatric donors, even younger than 10 years, provided results comparable with those achievable using adult donors. The similar incidence of arterial complications among patients receiving LLS or ERG suggests that maintenance of the celiac trunk with LLS is not detrimental for right-sided grafts.
authors.affiliation: Centro Trapianti di Fegato, Chirurgia III, Ospedali Riuniti, Bergamo, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Cescon
authors.forename: Marco
authors.initials: M
authors.lastname: Spada
authors.forename: Michele
authors.initials: M
authors.lastname: Colledan
authors.forename: Enzo
authors.initials: E
authors.lastname: Andorno
authors.forename: Umberto
authors.initials: U
authors.lastname: Valente
authors.forename: Giorgio
authors.initials: G
authors.lastname: Rossi
authors.forename: Paolo
authors.initials: P
authors.lastname: Reggiani
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Grazi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tisone
authors.forename: Pietro
authors.initials: P
authors.lastname: Majno
authors.forename: Xavier
authors.initials: X
authors.lastname: Rogiers
authors.forename: Manuel Lopez
authors.initials: ML
authors.lastname: Santamaria
authors.forename: Umberto
authors.initials: U
authors.lastname: Baccarani
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Ettorre
authors.forename: Umberto
authors.initials: U
authors.lastname: Cillo
authors.forename: Massimo
authors.initials: M
authors.lastname: Rossi
authors.forename: Mario
authors.initials: M
authors.lastname: Scalamogna
authors.forename: Bruno
authors.initials: B
authors.lastname: Gridelli
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality / Q000502:physiology; D008297:Male; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome