title: Whole liver versus split liver versus living donor in the adult recipient: an analysis of outcomes by graft type.
abstract: BACKGROUND
  We studied patient and graft survival rates in adult liver transplant recipients, analyzing outcomes based on donor source (deceased donor [DD] vs. living donor [LD]) and graft type (whole liver vs. partial liver).
  
  
  METHODS
  A retrospective database analysis of all adult liver transpants performed at our center over a 7-year period of time.
  
  
  RESULTS
  Between 1999 and 2005, 384 liver transplants were performed in adult recipients, either as a whole liver from a deceased donor (DD-WL, n=284), split liver from a DD (DD-SL, n=31), or a partial transplant from a living donor (LD, n=69). DD-SL transplants were performed with a full right or left lobe graft, while LD transplants used the right lobe. Demographic differences in the three groups were most noticeable for lower model for end-stage liver disease scores in LD recipients (P<0.001) and younger donor age in DD-SL recipients (P<0.001). Superior graft survival results were seen in LD recipients versus either DD-WL recipients or DD-SL recipients (P=0.02 and P=0.05, respectively). Multivariate analysis showed hepatitis C (HR=1.53, P=0.05) and hepatocellular carcinoma (HR=1.74, P=0.03) to be significant risk factors for patient survival. Hepatitis C (HR=1.61, P=0.03) and donor age more than 50 (HR=1.64, P=0.04) were significant risk factors for graft survival. However, neither graft type nor donor source were significant independent risk factors for patient or graft survival.
  
  
  CONCLUSIONS
  Our data suggests that the status of the recipient is probably a more important determinant of outcome than graft type or donor source.
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, MN, USA. humar001@umn.edu
authors.forename: Abhinav
authors.initials: A
authors.lastname: Humar
authors.forename: Joy
authors.initials: J
authors.lastname: Beissel
authors.forename: Shaina
authors.initials: S
authors.lastname: Crotteau
authors.forename: Raja
authors.initials: R
authors.lastname: Kandaswamy
authors.forename: John
authors.initials: J
authors.lastname: Lake
authors.forename: William
authors.initials: W
authors.lastname: Payne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D002423:Cause of Death; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016031:Liver Transplantation / Q000276:immunology / Q000401:mortality / Q000502:physiology / Q000706:statistics & numerical data*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods; D011183:Postoperative Complications / Q000145:classification; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome