Split liver transplantation: a single center experience

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Abstract

Background: Split liver transplantation is used worldwide and allows for an increase of donor organ pool, especially for pediatric recipients. Donor selection, some aspects of surgical techniques and long-term results remain to be important issues of split liver transplantation.

Aim: To analyze our own clinical results of split liver transplantation, basic principles of deceased donor selection and specifics of surgical technique.

Materials and methods: From May 2008 to December 2019, 32 cases of division of the deceased donor liver for transplantation to two recipients have been performed (64 split liver transplantations). Liver was divided into the left lateral section and the extended right lobe in 30 cases (“classical split”), and into the left lobe and right lobe in two cases (“full-split”). In 22 cases, the liver grafts were split in situ and in 10, ex-situ.

Results: In the recipients of left-side transplants (left lateral section and whole left lobe), the one-, three-, and five-year survival rates were 80, 80, and 60%, respectively. In the right-sided transplant recipients (extended right lobe and right lobe), the one-, three-, and five-year survival rates were 93.3, 89.4, and 89.4%, respectively (p = 0.167). The most probable risk factors for mortality in the univariate analysis were liver retransplantation (p = 0.047) and patient’s weight (p = 0.04).

Conclusion: For split transplantation, it is advisable to consider donors with a high-quality liver. This technique demonstrates satisfactory results and can be viewed as effective for patients with terminal liver diseases.

About the authors

S. V. Gautier

Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: fake@neicon.ru
ORCID iD: 0000-0003-0633-678X

Sergey V. Gautier – MD, PhD, Professor, Member of Russ. Acad. Sci., Director; Head of the Chair of Transplantology and Artificial Organs

1 Shchukinskaya ul., Moscow, 123182;

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

A. R. Monakhov

Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: a.r.monakhov@gmail.com
ORCID iD: 0000-0002-3537-6601

Artem R. Monakhov – MD, PhD, Head of Surgical Department No. 2 (Liver Transplantation); Assistant, Chair of Transplantology and Artificial Organs

1 Shchukinskaya ul., Moscow, 123182, tel.: +7 (906) 078 16 21;

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

O. M. Tsiroulnikova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: fake@neicon.ru
ORCID iD: 0000-0003-3965-5277

Olga M. Tsiroulnikova – MD, PhD, Professor, Chair of Transplantology and Artificial Organs

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

R. A. Latypov

Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs

Email: fake@neicon.ru

Robert A. Latypov – MD, PhD, Surgeon, Surgical Department No. 3

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

T. A. Dzhanbekov

Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs

Email: fake@neicon.ru

Timur A. Dzhanbekov – MD, PhD, Pediatric Surgeon, Surgical Department No. 2

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

S. V. Mescheryakov

Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs

Email: fake@neicon.ru

Sergey V. Mescheryakov – Surgeon, Surgical Department No. 2

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

K. O. Semash

Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs

Email: fake@neicon.ru
ORCID iD: 0000-0001-5830-5235

Konstantin O. Semash – Surgeon, Surgical Department No. 2

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

S. I. Zubenko

Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs

Email: fake@neicon.ru

Stepan I. Zubenko – Surgeon, Surgical Department No. 2

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

Kh. M. Khizroev

Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs

Email: fake@neicon.ru

Khizry M. Khizroev – MD, PhD, Senior Research Fellow, Surgical Department No. 2

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

E. V. Chekletsova

Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs

Email: fake@neicon.ru

Elena V. Chekletsova – MD, PhD, Pediatrician, Clinical and Diagnostic Department

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

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Copyright (c) 2020 Gautier S.V., Monakhov A.R., Tsiroulnikova O.M., Latypov R.A., Dzhanbekov T.A., Mescheryakov S.V., Semash K.O., Zubenko S.I., Khizroev K.M., Chekletsova E.V.

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