Background. Split liver transplantation (SLT) for two adult recipients is still considered a challenging procedure, especially when subjected to model for end-stage liver disease (MELD)-based allocation criteria.Methods. Twenty-two SLTs were performed in adult recipients in a European center operating within a MELD-oriented system. Thirteen right-sided grafts and nine left-sided grafts were used. Right-sided grafts included I I extended right grafts and two full right grafts. Left-sided grafts included six left lateral segment grafts and three full left grafts. Ninety-three percent of donors were allocated based on MELD score. Median graft-to-recipient body weight ratio was 1.53 (range 1.07-2.11) with right-sided grafts and 0.81 (range 0.67-1.11) with left-sided grafts. Liver cirrhosis (46%) and metabolic/genetic disorders (56%) were the main indications for transplant in recipients of right and left grafts, respectively.Results. Overall patient and graft survival were 90% and 86%. Patient survival was 84% in recipients of right grafts and 100% in recipients of left grafts. Graft survival was 84% and 89%, respectively. Vascular and biliary complications Occurred in 14% and 4% of cases. Postoperative serum levels of total bilirubin were significantly higher in recipients of left-sided grafts versus right-sided grafts on postoperative days 7 and 14. Prothrombin activity was significantly lower in recipients of left-sided grafts versus right-sided grafts on postoperative days 3 and 7.Conclusions. SLT for two adult recipients can be successfully performed even using left lateral segments by assigning one graft according to MELD score, and with a more liberal allocation of the second graft.

Conventional split liver transplantation for two adult recipients: a recent experience in a single European center / CESCON, MATTEO; GRAZI, GIAN LUCA; RAVAIOLI, MATTEO; ERCOLANI, GIORGIO; DEL GAUDIO, MASSIMO; VIVARELLI, MARCO; CUCCHETTI, ALESSANDRO; ZANELLO, MATTEO; VETRONE, GAETANO; Lauro A.; PINNA, ANTONIO DANIELE. - In: TRANSPLANTATION. - ISSN 0041-1337. - STAMPA. - 88:(2009), pp. 1117-1122. [10.1097/TP.0b013e3181ba1096]

Conventional split liver transplantation for two adult recipients: a recent experience in a single European center

GRAZI, GIAN LUCA;
2009

Abstract

Background. Split liver transplantation (SLT) for two adult recipients is still considered a challenging procedure, especially when subjected to model for end-stage liver disease (MELD)-based allocation criteria.Methods. Twenty-two SLTs were performed in adult recipients in a European center operating within a MELD-oriented system. Thirteen right-sided grafts and nine left-sided grafts were used. Right-sided grafts included I I extended right grafts and two full right grafts. Left-sided grafts included six left lateral segment grafts and three full left grafts. Ninety-three percent of donors were allocated based on MELD score. Median graft-to-recipient body weight ratio was 1.53 (range 1.07-2.11) with right-sided grafts and 0.81 (range 0.67-1.11) with left-sided grafts. Liver cirrhosis (46%) and metabolic/genetic disorders (56%) were the main indications for transplant in recipients of right and left grafts, respectively.Results. Overall patient and graft survival were 90% and 86%. Patient survival was 84% in recipients of right grafts and 100% in recipients of left grafts. Graft survival was 84% and 89%, respectively. Vascular and biliary complications Occurred in 14% and 4% of cases. Postoperative serum levels of total bilirubin were significantly higher in recipients of left-sided grafts versus right-sided grafts on postoperative days 7 and 14. Prothrombin activity was significantly lower in recipients of left-sided grafts versus right-sided grafts on postoperative days 3 and 7.Conclusions. SLT for two adult recipients can be successfully performed even using left lateral segments by assigning one graft according to MELD score, and with a more liberal allocation of the second graft.
2009
88
1117
1122
CESCON, MATTEO; GRAZI, GIAN LUCA; RAVAIOLI, MATTEO; ERCOLANI, GIORGIO; DEL GAUDIO, MASSIMO; VIVARELLI, MARCO; CUCCHETTI, ALESSANDRO; ZANELLO, MATTEO; VETRONE, GAETANO; Lauro A.; PINNA, ANTONIO DANIELE
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1301235
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