The results of reduced-size liver transplantation, including split livers, in patients with end-stage liver disease

Alan Norman Langnas, W. C. Marujo, M. Inagaki, R. J. Stratta, R. P. Wood, B. W. Shaw

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

We initiated a policy of using RSLT in critically ill patients in June of 1988. Since that time we have performed 30 RSLTs in 29 patients, including 28 children and 1 adult. The mean age of the children was 27 months (range 1 month to 10 years) with 14 (52%) being 1 year of age or less. The mean weight was 11.3 kg (range 250 kg) with 20 being 10 kg or less. A total of 22 patients were in the intensive care unit at the time of RSLT including 9 who were intubated. Of the 30 RSLTs, 23 were performed as a primary transplant while 7 were retransplants. Indications for primary transplantation included biliary atresia (n=ll), fulminant hepatic failure (n=5), neonatal hepatitis (n=4) and others (n=3). The RSLT was used in retransplantation for primary nonfunction (n=2), hepatic artery thrombosis (n=2), chronic rejection (n=2), and herpetic hepatitis (n=l). The size reductions included 18 left lobes, 7 left lateral segments, and 5 right lobes. This group includes the use of the split-liver technique, which was applied to 10 patients (5 livers). The median donor/recipient weight ratio for left lobe transplants was 2:1; left lateral segments was 7.3:1; and right lobes 1.6:1. One year actuarial patient and graft survivals were 68 and 65%, respectively, with a mean follow-up of 10.6 months. The number of children dying awaiting transplantation has been significantly reduced following the introduction of RSLD (3 of 115, 2.6% vs. 12 of 95, 13%; P<0.02).

Original languageEnglish (US)
Pages (from-to)387-391
Number of pages5
JournalTransplantation
Volume53
Issue number2
StatePublished - Feb 1992

Fingerprint

End Stage Liver Disease
Liver Transplantation
Liver
Hepatitis
Transplantation
Transplants
Biliary Atresia
Weights and Measures
Acute Liver Failure
Hepatic Artery
Graft Survival
Critical Illness
Intensive Care Units
Thrombosis
Tissue Donors

ASJC Scopus subject areas

  • Transplantation

Cite this

Langnas, A. N., Marujo, W. C., Inagaki, M., Stratta, R. J., Wood, R. P., & Shaw, B. W. (1992). The results of reduced-size liver transplantation, including split livers, in patients with end-stage liver disease. Transplantation, 53(2), 387-391.

The results of reduced-size liver transplantation, including split livers, in patients with end-stage liver disease. / Langnas, Alan Norman; Marujo, W. C.; Inagaki, M.; Stratta, R. J.; Wood, R. P.; Shaw, B. W.

In: Transplantation, Vol. 53, No. 2, 02.1992, p. 387-391.

Research output: Contribution to journalArticle

Langnas, AN, Marujo, WC, Inagaki, M, Stratta, RJ, Wood, RP & Shaw, BW 1992, 'The results of reduced-size liver transplantation, including split livers, in patients with end-stage liver disease', Transplantation, vol. 53, no. 2, pp. 387-391.
Langnas, Alan Norman ; Marujo, W. C. ; Inagaki, M. ; Stratta, R. J. ; Wood, R. P. ; Shaw, B. W. / The results of reduced-size liver transplantation, including split livers, in patients with end-stage liver disease. In: Transplantation. 1992 ; Vol. 53, No. 2. pp. 387-391.
@article{05bab18342d04ecd8adf45b060878452,
title = "The results of reduced-size liver transplantation, including split livers, in patients with end-stage liver disease",
abstract = "We initiated a policy of using RSLT in critically ill patients in June of 1988. Since that time we have performed 30 RSLTs in 29 patients, including 28 children and 1 adult. The mean age of the children was 27 months (range 1 month to 10 years) with 14 (52{\%}) being 1 year of age or less. The mean weight was 11.3 kg (range 250 kg) with 20 being 10 kg or less. A total of 22 patients were in the intensive care unit at the time of RSLT including 9 who were intubated. Of the 30 RSLTs, 23 were performed as a primary transplant while 7 were retransplants. Indications for primary transplantation included biliary atresia (n=ll), fulminant hepatic failure (n=5), neonatal hepatitis (n=4) and others (n=3). The RSLT was used in retransplantation for primary nonfunction (n=2), hepatic artery thrombosis (n=2), chronic rejection (n=2), and herpetic hepatitis (n=l). The size reductions included 18 left lobes, 7 left lateral segments, and 5 right lobes. This group includes the use of the split-liver technique, which was applied to 10 patients (5 livers). The median donor/recipient weight ratio for left lobe transplants was 2:1; left lateral segments was 7.3:1; and right lobes 1.6:1. One year actuarial patient and graft survivals were 68 and 65{\%}, respectively, with a mean follow-up of 10.6 months. The number of children dying awaiting transplantation has been significantly reduced following the introduction of RSLD (3 of 115, 2.6{\%} vs. 12 of 95, 13{\%}; P<0.02).",
author = "Langnas, {Alan Norman} and Marujo, {W. C.} and M. Inagaki and Stratta, {R. J.} and Wood, {R. P.} and Shaw, {B. W.}",
year = "1992",
month = "2",
language = "English (US)",
volume = "53",
pages = "387--391",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - The results of reduced-size liver transplantation, including split livers, in patients with end-stage liver disease

AU - Langnas, Alan Norman

AU - Marujo, W. C.

AU - Inagaki, M.

AU - Stratta, R. J.

AU - Wood, R. P.

AU - Shaw, B. W.

PY - 1992/2

Y1 - 1992/2

N2 - We initiated a policy of using RSLT in critically ill patients in June of 1988. Since that time we have performed 30 RSLTs in 29 patients, including 28 children and 1 adult. The mean age of the children was 27 months (range 1 month to 10 years) with 14 (52%) being 1 year of age or less. The mean weight was 11.3 kg (range 250 kg) with 20 being 10 kg or less. A total of 22 patients were in the intensive care unit at the time of RSLT including 9 who were intubated. Of the 30 RSLTs, 23 were performed as a primary transplant while 7 were retransplants. Indications for primary transplantation included biliary atresia (n=ll), fulminant hepatic failure (n=5), neonatal hepatitis (n=4) and others (n=3). The RSLT was used in retransplantation for primary nonfunction (n=2), hepatic artery thrombosis (n=2), chronic rejection (n=2), and herpetic hepatitis (n=l). The size reductions included 18 left lobes, 7 left lateral segments, and 5 right lobes. This group includes the use of the split-liver technique, which was applied to 10 patients (5 livers). The median donor/recipient weight ratio for left lobe transplants was 2:1; left lateral segments was 7.3:1; and right lobes 1.6:1. One year actuarial patient and graft survivals were 68 and 65%, respectively, with a mean follow-up of 10.6 months. The number of children dying awaiting transplantation has been significantly reduced following the introduction of RSLD (3 of 115, 2.6% vs. 12 of 95, 13%; P<0.02).

AB - We initiated a policy of using RSLT in critically ill patients in June of 1988. Since that time we have performed 30 RSLTs in 29 patients, including 28 children and 1 adult. The mean age of the children was 27 months (range 1 month to 10 years) with 14 (52%) being 1 year of age or less. The mean weight was 11.3 kg (range 250 kg) with 20 being 10 kg or less. A total of 22 patients were in the intensive care unit at the time of RSLT including 9 who were intubated. Of the 30 RSLTs, 23 were performed as a primary transplant while 7 were retransplants. Indications for primary transplantation included biliary atresia (n=ll), fulminant hepatic failure (n=5), neonatal hepatitis (n=4) and others (n=3). The RSLT was used in retransplantation for primary nonfunction (n=2), hepatic artery thrombosis (n=2), chronic rejection (n=2), and herpetic hepatitis (n=l). The size reductions included 18 left lobes, 7 left lateral segments, and 5 right lobes. This group includes the use of the split-liver technique, which was applied to 10 patients (5 livers). The median donor/recipient weight ratio for left lobe transplants was 2:1; left lateral segments was 7.3:1; and right lobes 1.6:1. One year actuarial patient and graft survivals were 68 and 65%, respectively, with a mean follow-up of 10.6 months. The number of children dying awaiting transplantation has been significantly reduced following the introduction of RSLD (3 of 115, 2.6% vs. 12 of 95, 13%; P<0.02).

UR - http://www.scopus.com/inward/record.url?scp=0026523748&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026523748&partnerID=8YFLogxK

M3 - Article

C2 - 1346730

AN - SCOPUS:0026523748

VL - 53

SP - 387

EP - 391

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 2

ER -