Ex vivo split-liver transplantation: The true right/left split

Parsia A. Vagefi, Justin Parekh, Nancy L. Ascher, John P. Roberts, Chris E. Freise

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background: Successful left lateral segment (sectionectomy) and right trisegmentectomy (trisectionectomy) split-liver transplantation (SLT) have been achieved. However, there are few reports of the use of true right/left splitting in SLT. Methods: A single-centre retrospective review of true right/left ex vivo split-liver transplants performed during the period 1993-2010 was conducted. Nine cadaveric liver grafts underwent splitting and the resultant 18 allografts were used in transplants performed at the study centre. Results: In the nine right lobe recipients, 10-year patient and graft survival rates were both 74%. There were no vascular complications, one biliary complication and one re-exploration. In the nine left lobe recipients, 10-year patient and graft survival rates were 78% and 66%, respectively. Postoperative complications included six biliary complications, four of which required surgical revision and all of which occurred within 5 months of transplantation, and two vascular complications, including one early hepatic artery thrombosis (HAT) and one late HAT, one of which required retransplantation. Five left lobe recipients required re-exploration, and one patient developed small-for-size syndrome following SLT, which resolved with conservative measures. Conclusions: True right/left ex vivoâ€...SLT remains a viable option for facilitating the expansion of the adult cadaver donor pool and allows for excellent patient and graft survival. Postoperative morbidity remains high, especially in recipients of the left lobe graft, and must be balanced with the benefits to be derived from transplant.

Original languageEnglish (US)
Pages (from-to)267-274
Number of pages8
JournalHPB
Volume16
Issue number3
DOIs
StatePublished - Mar 2014

    Fingerprint

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Vagefi, P. A., Parekh, J., Ascher, N. L., Roberts, J. P., & Freise, C. E. (2014). Ex vivo split-liver transplantation: The true right/left split. HPB, 16(3), 267-274. https://doi.org/10.1111/hpb.12113