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EnglishBACKGROUND: Split liver transplantation (SLT) for two adult recipients is still considered a challenging procedure, especially when subjected to model for end-stage liver disease (MELD)-based allocation criteria. METHODS: Twenty-two SLTs were performed in adult recipients in a European center operating within a MELD-oriented system. Thirteen right-sided grafts and nine left-sided grafts were used. Right-sided grafts included 11 extended right grafts and two full right grafts. Left-sided grafts included six left lateral segment grafts and three full left grafts. Ninety-three percent of donors were allocated based on MELD score. Median graft-to-recipient body weight ratio was 1.53 (range 1.07-2.11) with right-sided grafts and 0.81 (range 0.67-1.11) with left-sided grafts. Liver cirrhosis (46%) and metabolic/genetic disorders (56%) were the main indications for transplant in recipients of right and left grafts, respectively. RESULTS: Overall patient and graft survival were 90% and 86%. Patient survival was 84% in recipients of right grafts and 100% in recipients of left grafts. Graft survival was 84% and 89%, respectively. Vascular and biliary complications occurred in 14% and 4% of cases. Postoperative serum levels of total bilirubin were significantly higher in recipients of left-sided grafts versus right-sided grafts on postoperative days 7 and 14. Prothrombin activity was significantly lower in recipients of left-sided grafts versus right-sided grafts on postoperative days 3 and 7. CONCLUSIONS: SLT for two adult recipients can be successfully performed even using left lateral segments by assigning one graft according to MELD score, and with a more liberal allocation of the second graft.
| Titolo: | Conventional split liver transplantation for two adult recipients: a recent experience in a single European center |
| Autore/i: | CESCON, MATTEO; GRAZI, GIAN LUCA; RAVAIOLI, MATTEO; ERCOLANI, GIORGIO; DEL GAUDIO, MASSIMO; VIVARELLI, MARCO; CUCCHETTI, ALESSANDRO; ZANELLO, MATTEO; VETRONE, GAETANO; Lauro A.; PINNA, ANTONIO DANIELE |
| Autore/i Unibo: | |
| Anno: | 2009 |
| Rivista: | |
| Digital Object Identifier (DOI): | http://dx.doi.org/10.1097/TP.0b013e3181ba1096 |
| Abstract: | BACKGROUND: Split liver transplantation (SLT) for two adult recipients is still considered a challenging procedure, especially when subjected to model for end-stage liver disease (MELD)-based allocation criteria. METHODS: Twenty-two SLTs were performed in adult recipients in a European center operating within a MELD-oriented system. Thirteen right-sided grafts and nine left-sided grafts were used. Right-sided grafts included 11 extended right grafts and two full right grafts. Left-sided grafts included six left lateral segment grafts and three full left grafts. Ninety-three percent of donors were allocated based on MELD score. Median graft-to-recipient body weight ratio was 1.53 (range 1.07-2.11) with right-sided grafts and 0.81 (range 0.67-1.11) with left-sided grafts. Liver cirrhosis (46%) and metabolic/genetic disorders (56%) were the main indications for transplant in recipients of right and left grafts, respectively. RESULTS: Overall patient and graft survival were 90% and 86%. Patient survival was 84% in recipients of right grafts and 100% in recipients of left grafts. Graft survival was 84% and 89%, respectively. Vascular and biliary complications occurred in 14% and 4% of cases. Postoperative serum levels of total bilirubin were significantly higher in recipients of left-sided grafts versus right-sided grafts on postoperative days 7 and 14. Prothrombin activity was significantly lower in recipients of left-sided grafts versus right-sided grafts on postoperative days 3 and 7. CONCLUSIONS: SLT for two adult recipients can be successfully performed even using left lateral segments by assigning one graft according to MELD score, and with a more liberal allocation of the second graft. |
| Data prodotto definitivo in UGOV: | 2009-11-20 11:53:53 |
| Appare nelle tipologie: | 1.01 Articolo in rivista |
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http://hdl.handle.net/11585/79564
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