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In Situ Split Liver Transplantation for 2 Adult Recipients: A Single-Center Experience

Dong-Hwan Jung, Shin Hwang, Gi-Won Song, Chul-Soo Ahn, Deok-Bog Moon, Ki-Hun Kim, Tae-Yong Ha, Gil-Chun Park, Wan-Jun Kim, Woo-Hyoung Kang, Seok-Hwan Kim, Sung-Gyu Lee

(Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea)

Ann Transplant 2017; 22:230-240

DOI: 10.12659/AOT.902567


BACKGROUND: Split liver transplantation (SLT) for 2 adult patients by in situ splitting is rarely reported. This study analyzed the outcomes of SLT for 2 adult recipients at a single center.
MATERIAL AND METHODS: From 2003 to 2014, we performed 16 adult SLTs from 8 deceased donors using in situ splitting technique. We investigated the results of SLT and compared the outcomes of SLT with those of 393 cases of primary whole liver transplantation (WLT).
RESULTS: All SLT donors were male. Eight recipients received right liver graft. Seven recipients received left liver graft. One recipient received dual-donor liver transplantation with 2 left-liver grafts (1 left liver graft from a living donor). The mean age of the recipients was 49.6±7 years. The Model for End-Stage Liver Disease (MELD) score of the recipients was 21.3±8.6. The mean cold ischemic time was 345.6±311.7 minutes. Graft and patient survival rates were 75.0% and 81.3%, respectively, at both 1 year and 5 years. There were 2 cases of biliary complication and 3 cases of vascular complication, but no incidence of arterial complication or small-for-size graft syndrome. The donor age of the SLT group was younger than that of the WLT group (p<0.001). The MELD score of the SLT group was lower than that of the WLT group (p=0.01). Patient and graft survival rates did not differ significantly between the SLT and WLT groups (p=0.47 and p=0.78, respectively).
CONCLUSIONS: In situ SLT for 2 adults is a feasible option to expand door pools in selected situations.

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