Bahador A, Salahi H, Nikeghbalian S, Dehghani S M, Kakaei F, Sabet B, Kazemi K, Rajaei E, Gholami S, Malek-Hosseini S A
Department of Hepatobiliary and Transplantation Surgery, Shiraz University of Medical Sciences, Shiraz Transplant Center, Shiraz, Iran.
Transplant Proc. 2009 Sep;41(7):2872-4. doi: 10.1016/j.transproceed.2009.07.052.
Cadaveric organ splitting emerged from an improved understanding of the surgical anatomy of the liver as a possible mechanism to expand the organ pool. In this study, we have reported our first series of split liver transplantations (SLT).
From June 2006 to June 2008, we performed 17 pairs of SLT: 70.6% ex situ and 29.4% in situ. The mean age of the donors (32 males, 2 females) was 23.15 +/- 9 years. All of them had been stable at the time of harvest according to vital signs, liver function tests, electrolytes, and urine output. The decision on splitting was made by the surgical team according to the donor's status and the urgency of the recipient.
The main indications were biliary atresia (17.6%) followed by Wilson disease (14.7%) and cryptogenic cirrhosis (14.7%). The left lateral segment and the left lobe were used in 6 and 11 cases, respectively. In-hospital mortalities for the pediatric and adult groups were 68.4% and 26.7%, respectively. Primary graft nonfunction (52.9%), vascular complications (29.4%), sepsis (11.8%), and biliary complications (5.9%) were the main causes of mortality.
Our experience indicated that SLT showed a high rate of mortality and morbidity.
