split liver
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2022 ◽  
Vol 35 ◽  
Author(s):  
Xingyu Pu ◽  
Diao He ◽  
Anque Liao ◽  
Jian Yang ◽  
Tao Lv ◽  
...  

There are two causes of graft compression in the large-for-size syndrome (LFSS). One is a shortage of intra-abdominal space for the liver graft, and the other is the size discrepancy between the anteroposterior dimensions of the liver graft and the lower right hemithorax of the recipient. The former could be treated using delayed fascial closure or mesh closure, but the latter may only be treated by reduction of the right liver graft to increase space. Given that split liver transplantation has strict requirements regarding donor and recipient selections, reduced-size liver transplantation, in most cases, may be the only solution. However, surgical strategies for the reduction of the right liver graft for adult liver transplantations are relatively unfamiliar. Herein, we introduce a novel strategy of HuaXi-ex vivo right posterior sectionectomy while preserving the right hepatic vein in the graft to prevent LFSS and propose its initial indications.


2021 ◽  
Vol 11 (1) ◽  
pp. 215
Author(s):  
Haris Muhammad ◽  
Duha Zaffar ◽  
Aniqa Tehreem ◽  
Peng-Sheng Ting ◽  
Cem Simsek ◽  
...  

The ideal management for end stage liver disease, acute liver failure, and hepatocellular carcinoma (HCC), within specific criteria, is liver transplantation (LT). Over the years, there has been a steady increase in the candidates listed for LT, without a corresponding increase in the donor pool. Therefore, due to organ shortage, it has been substantially difficult to reduce waitlist mortality among patients awaiting LT. Thus, marginal donors such as elderly donors, steatotic donors, split liver, and donors after cardiac death (DCD), which were once not commonly used, are now considered. Furthermore, it is encouraging to see the passing of Acts, such as the HIV Organ Policy Equity (HOPE) Act, enabling further research and development in utilizing HIV grafts. Subsequently, the newer antivirals have aided in successful post-transplant period, especially for hepatitis C positive grafts. However, currently, there is no standardization, and protocols are center specific in the usage of marginal donors. Therefore, studies with longer follow ups are required to standardize its use.


2021 ◽  
pp. 214-240
Author(s):  
Lainie Friedman ◽  
J. Richard Thistlethwaite, Jr

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.


2021 ◽  
Author(s):  
Mary G. Bowring ◽  
Allan B. Massie ◽  
Kathleen B. Schwarz ◽  
Andrew M. Cameron ◽  
Elizabeth A. King ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daisuke Ishii ◽  
Naoto Matsuno ◽  
Mikako Gochi ◽  
Hiroyoshi Iwata ◽  
Tatsuya Shonaka ◽  
...  

AbstractThis study examined the efficacy of end-ischemic hypothermic oxygenated machine perfusion preservation (HOPE) using an originally developed machine perfusion system for split-liver transplantation. Porcine split-liver grafts were created via 75% liver resection after 10 min of warm ischemia. In Group 1, grafts were preserved by simple cold storage (CS) for 8 h (CS group; n = 4). In Group 2, grafts were preserved by simple CS for 6 h and end-ischemic HOPE for 2 h (HOPE group; n = 5). All grafts were evaluated using an isolated ex vivo reperfusion model with autologous blood for 2 h. Biochemical markers (aspartate aminotransferase and lactate dehydrogenase levels) were significantly better immediately after reperfusion in the HOPE group than in the CS group. Furthermore, the HOPE group had a better histological score. The levels of inflammatory cytokines (tumor necrosis factor-α, interferon-γ, interleukin-1β, and interleukin-10) were significantly lower after reperfusion in the HOPE group. Therefore, we concluded that end-ischemic HOPE for split-liver transplantation can aid in recovering the graft function and reducing ischemia–reperfusion injury. HOPE, using our originally developed machine perfusion system, is safe and can improve graft function while attenuating liver injury due to preservation.


2021 ◽  
Author(s):  
Dimitri Sneiders ◽  
Anne‐Baue R.M. van Dijk ◽  
Wojciech G. Polak ◽  
Darius F. Mirza ◽  
M. Thamara P.R. Perera ◽  
...  

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ngee-Soon Lau ◽  
Ken Liu ◽  
Geoffrey McCaughan ◽  
Michael Crawford ◽  
Carlo Pulitano

2021 ◽  
Author(s):  
Mustafa Nazzal ◽  
Erik C. Madsen ◽  
Austin Armstrong ◽  
Johan Nispen ◽  
Vidul Murali ◽  
...  

Medicine ◽  
2021 ◽  
Vol 100 (39) ◽  
pp. e27369
Author(s):  
Kun-Ming Chan ◽  
Hao-Chien Hung ◽  
Jin-Chiao Lee ◽  
Tsung-Han Wu ◽  
Yu-Chao Wang ◽  
...  

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