Ann Surg 1998 Feb;227(2):282-8

Split liver transplantation: King's College Hospital experience

Rela M, Vougas V, Muiesan P, Vilca-Melendez H, Smyrniotis V, Gibbs P, Karani J,
Williams R, Heaton N

Liver Transplantation Surgical Service, Department of Radiology, King's College
Hospital, London, UK

Abstract

BACKGROUND: The purpose of split liver transplantation is to increase the source
of pediatric grafts without compromising the adult donor pool. Early results
have been discouraging because of technical complications and selection of poor
risk patients. METHODS: The results of a single center experience of 41 split
liver transplantations were analyzed. Patient and graft survival and
complications related to the technique were analyzed. RESULTS: Patient and graft
survival for the whole group was 90% and 88% respectively at a median follow up
of 12 months (range 6-70 months). Patient and graft survival for the right lobe
graft was 95% and the left lateral segment 86% and 82% respectively. Four
patients died, of which two of the patients were first two splits following
technical complications. Two others died, one from cerebral lymphoma and the
other of multiorgan failure secondary to sepsis. One patient has been
retransplanted for chronic biliary sepsis. CONCLUSION: Split liver
transplantation has now become an acceptable treatment option for both adult and
pediatric recipients with end stage liver disease. Right lobe recipients are not
disadvantaged by the procedure. Good results can be achieved with better patient
selection and by the use of good quality organs