Split liver transplantation: a single center experience

Abstract

Background: Split liver transplantation is used worldwide and allows for an increase of donor organ pool, especially for pediatric recipients. Donor selection, some aspects of surgical techniques and long-term results remain to be important issues of split liver transplantation.Aim: To analyze our own clinical results of split liver transplantation, basic principles of deceased donor selection and specifics of surgical technique.Materials and methods: From May 2008 to December 2019, 32 cases of division of the deceased donor liver for transplantation to two recipients have been performed (64 split liver transplantations). Liver was divided into the left lateral section and the extended right lobe in 30 cases (“classical split”), and into the left lobe and right lobe in two cases (“full-split”). In 22 cases, the liver grafts were split in situ and in 10, ex-situ.Results: In the recipients of left-side transplants (left lateral section and whole left lobe), the one-, three-, and five-year survival rates were 80, 80, and 60%, respectively. In the right-sided transplant recipients (extended right lobe and right lobe), the one-, three-, and five-year survival rates were 93.3, 89.4, and 89.4%, respectively (p = 0.167). The most probable risk factors for mortality in the univariate analysis were liver retransplantation (p = 0.047) and patient’s weight (p = 0.04).Conclusion: For split transplantation, it is advisable to consider donors with a high-quality liver. This technique demonstrates satisfactory results and can be viewed as effective for patients with terminal liver diseases.