Partial liver transplantation-living donor liver transplantation and split liver transplantation

Due to the shortage of organs for transplantation, different surgical alternatives have been developed, as split liver transplantation (SLT) and living-donor liver transplantation. In classical SLT, the liver of a cadaveric donor is divided and two allografts are obtained, one corresponding to segments 2-3 and the other to segments 1, 4–8. In order to produce two grafts from one liver for two adult recipients, splitting of the liver can create a right graft including segments 5–8 and a left graft with segments 1–4. Splitting of the liver can be performed during procurement (in situ) or on the bench (ex situ). The aim of our study is to describe the first case of in situ full-right full-left split liver transplantation, with focus on donor and recipient surgery.

Download Full-text

Expanding Living Donor Liver Transplantation

10.1093/oso/9780197618202.003.0009 ◽

2021 ◽

pp. 214-240

Author(s):

Lainie Friedman ◽

J. Richard Thistlethwaite, Jr

Keyword(s):

Liver Transplantation ◽

Young Children ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Ethical Issues ◽

Deceased Donor ◽

Donor Liver ◽

Donor Liver Transplantation ◽

Split Liver ◽

Donor Liver Transplant

In the 1980s in the United States (US), young children in liver failure were at proportionately greater risk of dying on the deceased donor liver transplant (DDLT) waitlist than adults because of the lack of appropriately sized grafts. This led to the development of two deceased donor liver techniques—reduced-size (trimming the graft to decrease its size) and split-liver (where one liver could provide grafts to two candidates). These developments decreased but did not eliminate waitlist mortality for young children. Split-liver DDLT paved the way for living donor liver transplantation (LDLT) in children using the lateral segments of the left lobe. Pediatric LDLT began slowly at only a few centers with successful donor and recipient results. Adult-to-adult LDLT expanded quickly despite many US programs having limited experience, low volumes, and significant donor morbidity. The ethical issues raised by the rapid expansion of adult-to-adult LDLT in the US are discussed.

Download Full-text

2nd International Symposium on Small For Size Syndrome in liver surgery, split liver and living donor liver transplantation: towards new frontiers

Transplant International ◽

10.1111/j.1432-2277.2004.00098.x ◽

2005 ◽

Vol 18 (2) ◽

pp. 260-260

Keyword(s):

Liver Transplantation ◽

International Symposium ◽

Liver Surgery ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Donor Liver ◽

Donor Liver Transplantation ◽

Split Liver ◽

Small For Size

Download Full-text

Anatomical and Surgical Basis for Adult Living Donor Liver Transplantation with the Right Liver Lobe

Acta Medica Marisiensis ◽

10.2478/amma-2014-0028 ◽

2014 ◽

Vol 60 (3) ◽

pp. 129-132

Author(s):

C. Borz ◽

D. Marian ◽

T. Bara ◽

O. Jimborean ◽

T. Bara ◽

...

Keyword(s):

Liver Transplantation ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Liver Graft ◽

Main Concern ◽

Donor Liver ◽

Liver Lobe ◽

Donor Liver Transplantation ◽

Split Liver ◽

The Right

Abstract Liver transplantation is now a standard procedure for the treatment of end stage liver diseases. Since 1968 until 2012, a number of 113,627 liver transplantations were performed in Europe, in 28 countries and 153 institutions. Despite these impressive figures the waiting list is growing every year. Transplant surgeons were preoccupied to find new ways to increase the donor pool. Among them: reduced size liver transplantation, split liver technique and more recently living donor liver transplantation. At first in the early `90, living donor liver transplantation was used for pediatric patients because the left lateral hepatic segments were harvested. This graft is too small for the metabolic demands of an adult patient. So the next step was the harvesting of the right liver lobe from the donor and transplantation to adult patients. Living donor liver transplantation has gained fast a wide acceptance but there are a few issues to discuss. The main concern is about the donor safety which is a healthy person undergoing major surgery with potential risks. Also the surgical technique evolved due to a better understanding of the anatomy and physiology of the liver and the right liver graft. We discuss here the anatomical and surgical basis for living donor liver transplantation with the right liver lobe.

Download Full-text

Adult-to-Adult Living-Donor Liver Transplantation

Swiss Surgery ◽

10.1024/1023-9332.9.5.227 ◽

2003 ◽

Vol 9 (5) ◽

pp. 227-236 ◽

Cited By ~ 3

Author(s):

Majno ◽

Mentha ◽

Berney ◽

Bühler ◽

Giostra ◽

...

Keyword(s):

Liver Transplantation ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Therapeutic Option ◽

Donor Liver ◽

Donor Liver Transplantation ◽

Multidisciplinary Program ◽

First Case ◽

Living Donor Transplantation ◽

The Right

Living donor liver transplantation is a relatively new procedure in which the right side of the liver is harvested in a healthy donor and transplanted into a recipient. After the first case in 1994, over 3000 cases have been done worldwide. This review summarizes the reasons why the procedure is needed, describes its main technical aspects, highlights the boundaries in which it can be done safely, summarizes the current experience worldwide and describes the main points of the program in our unit. We argue that living-donor transplantation is a viable alternative to a long time on the waiting list for several patients, and it can be performed safely and successfully provided that all precautions are undertaken to minimize the risks in the donor and to increase the chances of a good outcome in the recipients. If these prerequisites are met, and within the framework of a structured multidisciplinary program, we believe that living-donor liver transplantation should be funded by health insurances as a recognized therapeutic option.

Download Full-text