Transplantation 1995 May 27;59(10):1371-6

Split liver transplantation in Europe--1988 to 1999

de Ville de Goyet J
European Split Liver Registry, Cliniques St. Luc, University of Louvain Medical
School, Brussels, Belgium

Abstract
The shortage of liver grafts results in the fact that 8% of potential recipients
die before receiving a graft. Liver graft division has therefore been proposed
to maximize the current available liver graft pool. However, the question of
benefit or additional risk for the recipient that this technique might carry
remains unanswered. The European Split Liver Registry was opened in March 1993
and reviewed retrospectively the clinical experience obtained at nine European
centers regarding the use of split liver transplants, during the five year
period from March 1988 to March 1993. From 50 donor livers, 100 grafts were
prepared: 2 grafts were discarded and the other 98 were transplanted in 53
children (2 times in 3 children) and 42 adults (2/42 in heterotopic position).
Sixty-three grafts were implanted in an urgent recipient (half of whom had acute
hepatic failure). Portal vein thrombosis, hepatic artery thrombosis, biliary
complications, and retransplantation rates were 4%, 11.5%, 18.7%, and 18.7%,
respectively. Most of these complications were unrelated to the technique
itself. Actual 6-month graft survivals of elective and urgent orthotopic
transplants were 80% and 61.3% in children, and 72.2% and 55.6% in adults;
actual 6-month patient survival rates for similar groupings were 88.9% and
61.1%, and 80% and 67.7%, respectively. Similar rates are reported after
conventional transplants in Europe. It is concluded that split liver
transplantation is an efficient transplant technique that benefits both urgent
patients who otherwise could have died before getting a graft in time and
elective patients