Abstract

Objective To investigate the safety and efficacy of splitting liver transplantation (SLT). Methods Clinical data of 10 donors and 19 recipients undergoing SLT in Institute of Organ Transplantation, General Hospital of Chinese People's Armed Police Forces from January 2008 to August 2013 were analyzed retrospectively. Of these 19 recipients, 9 were male, 10 were female and 9 were children,10 were adults. The age ranged from 7 months to 62 years with a median age of 31 years. The graft recipient weigh ratio (GRWR) was 1.0% to 4.3%. The informed consents of all patients were obtained and the ethical committee approval was received. The 10 cadaveric donor livers were split in vitro, in which 9 pair grafts were transplanted in 9 children and 8 adults respectively. The left lateral lobes (segmentⅡ,Ⅲ) were transplanted in children and the extended right lobes (segmentⅠ,Ⅳ-Ⅷ) in adults. The other donor liver was split in left and right half lobes and were transplanted in 2 adults. Piggyback liver transplantation was performed in the 9 children receiving left lateral lobes and 1 adult receiving right half lobe. Classic orthotopic liver transplantation was performed in the 8 adults receiving extended right lobes and 1 adult receiving left half lobe. Peri-operative death and complications of the patients were observed. The patients were followed up regularly for observing the survival situation. Results All the operations of 19 recipients were completed successfully. Seventeen cases were cured and discharged from hospital and 2 cases died during the peri-operative period. The 2 dead cases were both children. One died of septic shock 2 weeks after operation and the other died of primary liver graft nonfunction 2 d after liver retransplantation. Biliary leak of liver section occurred in 2 pediatric recipients and was cured by puncture drainage. One adult recipient with intrahepatic cholangiocarcinoma died of lung and bone multiple metastases 15 months after operation. Conclusions SLT is a safe and feasible transplant operation and it can help to alleviate the shortage of donor livers to some extent. Key words: Liver transplantation; Splitting; Postoperative complications

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