Split-liver transplantation with pediatric donors: a multicenter experience.
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.
Cescon
Matteo
M
Centro Trapianti di Fegato, Chirurgia III, Ospedali Riuniti, Bergamo, Italy.
Spada
Marco
M
Colledan
Michele
M
Andorno
Enzo
E
Valente
Umberto
U
Rossi
Giorgio
G
Reggiani
Paolo
P
Grazi
Gian Luca
GL
Tisone
Giuseppe
G
Majno
Pietro
P
Rogiers
Xavier
X
Santamaria
Manuel Lopez
ML
Baccarani
Umberto
U
Ettorre
Giuseppe Maria
GM
Cillo
Umberto
U
Rossi
Massimo
M
Scalamogna
Mario
M
Gridelli
Bruno
B
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