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

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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
Publication statusPublished - Feb 1992

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ASJC Scopus subject areas

  • Transplantation

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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.