Australian National Liver Transplantation Unit, Royal Prince Alfred Hospital.
Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Curr Opin Organ Transplant. 2021 Dec 1;26(6):675-680. doi: 10.1097/MOT.0000000000000938.
To assess the outcomes of split liver transplantation (SLT) in adults and children and evaluate its role in high-risk recipients with a high model for end-stage liver disease (MELD) score, an urgent indication or requiring retransplantation.
Split liver grafts in general have equivalent long-term survival outcomes to whole grafts despite an increase in biliary complications. Recent success and technical advances have encouraged use of these grafts in high-risk recipients. Split liver grafts can be used successfully in recipients with a high MELD score if there is adequate weight-matching. There are mixed results in urgent indication recipients and for retransplantation such that use in this group of patients remains controversial.
SLT addresses donor shortages by facilitating the transplant of two recipients from the same donor liver. By using careful donor and recipient selection criteria, SLT can achieve equivalent long-term outcomes to whole grafts. These grafts have been used successfully in recipients with a high MELD score, but should be used selectively in urgent indication recipients and for retransplantation.
评估成人和儿童劈离式肝移植（split liver transplantation，SLT）的结果，并评估其在高风险受体中的作用，这些受体的终末期肝病模型（model for end-stage liver disease，MELD）评分高、有紧急指征或需要再次移植。
尽管胆系并发症增加，但劈离式肝移植物的长期生存结果与全移植物相当。最近的成功和技术进步鼓励将这些移植物用于高危受者。如果有足够的体重匹配，劈离式肝移植物可成功用于 MELD 评分高的受者。在有紧急指征的受者和再次移植方面，结果喜忧参半，因此在这组患者中使用仍存在争议。
SLT 通过促进同一供肝的两名受者进行移植，解决了供体短缺的问题。通过仔细选择供体和受者的标准，SLT 可以实现与全移植物相当的长期结果。这些移植物已成功用于 MELD 评分高的受者，但在有紧急指征的受者和再次移植中应选择性使用。
