UNIGE document Scientific Article
previous document  unige:93789  next document
add to browser collection

Early complications after liver transplantation in children and adults: Are split grafts equal to each other and equal to whole livers?

Nowacka, Anna
show hidden authors show all authors [1 - 9]
Published in Pediatric transplantation. 2017, vol. 21, no. 4, e12908
Abstract Split-liver transplantation (LT) allows transplantation of two recipients from one deceased donor, thereby increasing pool of grafts. However, split LT may be hampered by technical problems, and split grafts are still considered suboptimal organs in some centres. We analysed the outcomes in split- and whole-liver recipients in a combined adult-to-paediatric transplantation programme. Records of paediatric and adult patients having undergone LT from 1999 to 2013 were analysed retrospectively. All splits were performed in situ. Adult split-graft recipients were matched 1:2 with whole-graft recipients (matching criteria: BMI, MELD, year of transplantation, age), and matched to the paediatric recipient transplanted from the same donor. Post-LT complications were classified according to the Clavien scale. Among children, 32 split- and 31 whole-graft recipients were analysed. Among adults, 20 split- and 40 matched whole-graft recipients were analysed. In both populations, the post-operative complications did not differ between split- and whole-graft recipients. There was no difference in 1-year graft and patient survival between split- and whole-graft recipients in paediatric (90% vs. 97%, 94% vs. 97%, respectively) and in adult recipients (89% in both, 89% vs. 92%, respectively). In the analysis of both recipients issued from the same donor, there was no association in the prevalence and severity of complications. A case-by-case analysis showed that split mortality was unrelated to LT in all but one patient (small-for-size left split graft). In the setting of careful donor selection, recipient matching and surgical skill, in situ split LT is an effective and safe technique to increase the number of available organs, and split livers should no longer considered marginal grafts.
PMID: 28261944
Full text
Article (Published version) (379 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Research groups Chirurgie viscérale (104)
Chirurgie viscérale (HUG)
Développement du tube digestif chez les vertébrés (900)
La transplantation d'îlots de Langerhans (623)
Recherche clinique en chirurgie pédiatrique (886)
Transplantation et hépatologie (905)
(ISO format)
MOUSSAOUI, Dehlia et al. Early complications after liver transplantation in children and adults: Are split grafts equal to each other and equal to whole livers?. In: Pediatric transplantation, 2017, vol. 21, n° 4, p. e12908. doi: 10.1111/petr.12908 https://archive-ouverte.unige.ch/unige:93789

507 hits



Deposited on : 2017-04-21

Export document
Format :
Citation style :