Current status and perspectives in split liver transplantation.
Growing experience with the liver splitting technique and favorable results equivalent to those of whole liver transplant have led to wider application of split liver transplantation (SLT) for adult and pediatric recipients in the last decade. Conversely, SLT for two adult recipients remains a challenging surgical procedure and outcomes have yet to improve. Differences in organ shortages together with religious and ethical issues related to cadaveric organ donation have had an impact on the worldwide distribution of SLT. Despite technical refinements and a better understanding of the complex liver anatomy, SLT remains a technically and logistically demanding surgical procedure. This article reviews the surgical and clinical advances in this field of liver transplantation focusing on the role of SLT and the issues that may lead a further expansion of this complex surgical procedure.
Andrea Lauterio, Stefano Di Sandro, Giacomo Concone, Riccardo De Carlis, Alessandro Giacomoni, Luciano De Carlis, Transplant Center, Department of General Surgery and Abdominal Transplantation, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
Andrea
A
Lauterio
Andrea Lauterio, Stefano Di Sandro, Giacomo Concone, Riccardo De Carlis, Alessandro Giacomoni, Luciano De Carlis, Transplant Center, Department of General Surgery and Abdominal Transplantation, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
Stefano
S
Di Sandro
Andrea Lauterio, Stefano Di Sandro, Giacomo Concone, Riccardo De Carlis, Alessandro Giacomoni, Luciano De Carlis, Transplant Center, Department of General Surgery and Abdominal Transplantation, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
Giacomo
G
Concone
Andrea Lauterio, Stefano Di Sandro, Giacomo Concone, Riccardo De Carlis, Alessandro Giacomoni, Luciano De Carlis, Transplant Center, Department of General Surgery and Abdominal Transplantation, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
Riccardo
R
De Carlis
Andrea Lauterio, Stefano Di Sandro, Giacomo Concone, Riccardo De Carlis, Alessandro Giacomoni, Luciano De Carlis, Transplant Center, Department of General Surgery and Abdominal Transplantation, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
Alessandro
A
Giacomoni
Andrea Lauterio, Stefano Di Sandro, Giacomo Concone, Riccardo De Carlis, Alessandro Giacomoni, Luciano De Carlis, Transplant Center, Department of General Surgery and Abdominal Transplantation, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
Luciano
L
De Carlis
D000367:Age Factors; D046148:Donor Selection; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D014850:Waiting Lists
Allocation policy; Ex vivo; Graft sharing; In situ; Liver transplantation; Organ shortage; Segmental liver; Split liver; Waiting list