title: Full-right-full-left split liver transplantation: the retrospective analysis of an early multicenter experience including graft sharing.
abstract: Full-right-full-left split liver transplantation divides a donor liver into two grafts to be transplanted in adult-size patients. Major technical and organizational difficulties have limited its application to few single center series. We retrospectively analyzed the long-term results of the first multicenter series of this procedure with graft sharing. Between November 1998 and January 2005, 43 transplants were performed by five centers from 23 full-right-full-left in situ split liver procedures; 65% of the grafts were shared. A total of 31 (72%) patients had complications above grade II; 3 (6.9%) were retransplanted. Hospital mortality was 23% with sepsis as the main cause. Six patients died in the long term, two of them for a road accident. A total of 27 patients are alive after a median follow-up of 3200 days (2035-4256). Actuarial survival at 1 and 10 years were 72.1%, 62.6% and 65.1%, 57.9%, respectively for patients and grafts. These figures are similar to those reported for adult living donor liver transplantation by the European Registry over a similar period. Multicenter collaboration in sharing of these grafts is feasible and can help facing the organizational limits, thus increasing diffusion of full-right-full-left split liver transplantation.
authors.affiliation: Department of Surgery, Ospedali Riuniti, Bergamo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Zambelli
authors.forename: E
authors.initials: E
authors.lastname: Andorno
authors.forename: L
authors.initials: L
authors.lastname: De Carlis
authors.forename: G
authors.initials: G
authors.lastname: Rossi
authors.forename: U
authors.initials: U
authors.lastname: Cillo
authors.forename: T
authors.initials: T
authors.lastname: De Feo
authors.forename: A
authors.initials: A
authors.lastname: Carobbio
authors.forename: A
authors.initials: A
authors.lastname: Giacomoni
authors.forename: G
authors.initials: G
authors.lastname: Bottino
authors.forename: M
authors.initials: M
authors.lastname: Colledan
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult