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2016 ; 22
(33
): 7500-6
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Split liver transplantation in adults
#MMPMID27672272
Hashimoto K
; Fujiki M
; Quintini C
; Aucejo FN
; Uso TD
; Kelly DM
; Eghtesad B
; Fung JJ
; Miller CM
World J Gastroenterol
2016[Sep]; 22
(33
): 7500-6
PMID27672272
show ga
Split liver transplantation (SLT), while widely accepted in pediatrics, remains
underutilized in adults. Advancements in surgical techniques and donor-recipient
matching, however, have allowed expansion of SLT from utilization of the right
trisegment graft to now include use of the hemiliver graft as well. Despite less
favorable outcomes in the early experience, better outcomes have been reported by
experienced centers and have further validated the feasibility of SLT.
Importantly, more than two decades of experience have identified key requirements
for successful SLT in adults. When these requirements are met, SLT can achieve
outcomes equivalent to those achieved with other types of liver transplantation
for adults. However, substantial challenges, such as surgical techniques,
logistics, and ethics, persist as ongoing barriers to further expansion of this
highly complex procedure. This review outlines the current state of SLT in
adults, focusing on donor and recipient selection based on physiology, surgical
techniques, surgical outcomes, and ethical issues.
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