Long-term results of in situ split-liver transplantation.
BACKGROUND
Split-liver transplantation (SLT) offers immediate expansion of the cadaver donor pool. The principal beneficiaries have been adult and pediatric recipients with excellent outcomes. This study analyzed a single-center experience of adult to adult in situ SLT in adult recipients.


METHODS
Fourteen consecutive adult-to-adult in situ SLT have been performed at our institution since 1998. The extended right lobe comprising segment 1 was transplanted in to adult patients, the left lateral segment, for pediatric transplants.


RESULTS
Donors of SLT were significantly younger (P = .03) than those of whole liver transplants. Survival rates of patients receiving a split liver were 83%, 73%, and 73% at 1, 3, and 5 years after the transplant respectively and grafts of 73%, 73%, and 73% for SLT and 76%, 70%, and 66% for whole liver transplants (P = .44). The rate of biliary complication after SLT was 21%, which was comparable to that after whole organ transplantation (17%). The incidence of hepatic artery thrombosis and primary nonfunction was not significantly different between split liver and whole organ transplantation performed during the same time period (7% versus 4.6% P = .67 and 7% versus 2.6% P = .32, respectively).


CONCLUSIONS
This limited single-center experience confirmed that both early and long-term results of SLT are comparable to those of traditional whole liver organ transplantation.
Baccarani
U
U
Department of Surgery & Transplantation, University Hospital of Udine, Udine, Italy. umberto.baccarani@uniud.it
Adani
G L
GL
Risaliti
A
A
Sainz-Barriga
M
M
Lorenzin
D
D
Chiarandini
P
P
Montanaro
D
D
Viale
P
P
Della Rocca
G
G
Bresadola
F
F
D000328:Adult; D002648:Child; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007165:Immunosuppression Therapy; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome