title: Extended right split liver graft for primary transplantation in children and adults.
abstract: Skepticism remains about the use of the extended right (ER) split graft (segments I, IV-VIII) for adult liver transplantation. We analyzed the results of primary liver transplantation performed with an ER graft in adult and in pediatric recipients. At our Institution, between October 1997 and June 2005, 32 primary liver transplantations with an ER graft were performed in 22 adult and 10 pediatric recipients. All the splitting procedures were performed in situ. Actuarial patient and graft survival among the adult recipients of the ER graft were 100% and 100% at 1 year, and 94% and 94% at 5 years. In the pediatric recipients, patient and graft survival were 90% and 79% both at 1 and 5 years. No hepatic artery thrombosis (HAT) occurred in the adult group, while in the pediatric recipients HAT occurred in two cases. A higher biliary morbidity occurred in the ER graft group when compared with the whole size graft 34% versus 13% (P = 0.03). However, this did not affect patient and graft survival. The results of this study may represent a further argument in favor of extensive splitting of all suitable grafts.
authors.affiliation: General Surgery, Liver and Lung Transplantation, Ospedali Riuniti, Largo Barozzi, Bergamo, Italy. vcorno@ospedaliriuniti.bergamo.it
authors.forename: Vittorio
authors.initials: V
authors.lastname: Corno
authors.forename: Michele
authors.initials: M
authors.lastname: Colledan
authors.forename: Maria Clara
authors.initials: MC
authors.lastname: Dezza
authors.forename: Michela
authors.initials: M
authors.lastname: Guizzetti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lucianetti
authors.forename: Gregorio
authors.initials: G
authors.lastname: Maldini
authors.forename: Domenico
authors.initials: D
authors.lastname: Pinelli
authors.forename: Mara
authors.initials: M
authors.lastname: Giovanelli
authors.forename: Marco
authors.initials: M
authors.lastname: Zambelli
authors.forename: Giuliano
authors.initials: G
authors.lastname: Torre
authors.forename: Mario
authors.initials: M
authors.lastname: Strazzabosco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D008107:Liver Diseases / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome