Experience with split liver transplantation in Vall Hebron Hospital

Abstract:

Introduction: We report our experience with the split liver technique in adults and children. Methods: From October 1992 to November 2001, we performed 11 liver splittings and transplanted 22 patients, 11 adults and 11 children. Liver splitting was performed ex situ in all patients except one in whom a mixed technique was used. Splitting was performed in the mid-line on three occasions and to the right of the falciform ligament on eight occasions, depending on the size of the pediatric recipient. Results: 1) Pediatric recipients. The mean age was 3.4 years and mean weight was 13 kg. Five patients required livers urgently for fulminant hepatitis (n= 2), urgent retransplantation (n= 2) and Byler's disease (n= 1). Six patients had biliary atresia. Five patients, four who underwent emergency surgery and one who underwent elective surgery, died in the postoperative period. The causes were perioperative multiorgan failure in three patients who underwent transplantation in a critical condition, cerebral hemorrhage in one patient who died at day 2 on withdrawal of the intracranial pressure sensor, and multiorgan failure secondary to portal thrombosis and hemorrhage in one patient. The remaining six patients were discharged and are currently alive. Technical complications consisted of portal thrombosis in one patient and biliary complications in three patients. 2) Adult recipients. The mean age was 53 years. Six patients presented hepatocarcinoma; five had liver cirrhosis and one had fibrolamellar liver cell carcinoma. Four patients had liver cirrhosis of different etiology and one had undergone retransplantation due to hepatitis C recurrence. In all patients …

Año de publicación:

2002

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