Split for Two Adults: What Is the Real Feasibility?

• Published in: Transplantation proceedings 2005-11, Vol.37 (9), p.3855-3856
• Main Authors: Ramia, J.M., Mansilla, A., Villar, J., Cabrera, M.A., Garrote, D., Ferron, J.A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Feasibility Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hepatectomy - methods; Humans; Liver Transplantation; Medical sciences; Middle Aged; Patient Selection; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue and Organ Harvesting - methods; Tissue Donors; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2005.10.067

A split liver for two adults is a good theoretical option but the number of cases is low. We have tried to assess the feasibility of this technique. From April 2002 to April 2004, we evaluated 81 donors of which only 59 (72.8%) were used for transplantation of which 10 were grafted in other centers (pediatric or emergency code). Among the 49 donors the criteria for splitting were: ages >14 and 70 and 3 days ( n = 9 [18.3%]), Na + > 160 ( n = 1 [2%]), blood liver test elevated ( n = 5 [10.2%]), steatosis ( n = 6 [12.2%]), and procurement outside our center ( n = 20 [40.8%]). The donors not suitable for splitting had: only one criteria ( n = 12 [24.4%]; 2 ( n = 23 [46.9%], 3 ( n = 6 [12.2%]) or 4 ( n = 2 [4.1%]). If we had had two suitable recipients, we could performed six more liver transplantations (12.2% increase). The theoretical feasibility of a split liver for two adults is 12.2%, but the actual probability is lower because of lack of two adequate candidates.