Split-liver transplantation in the United States: outcomes of a national survey

[Guest guest]

Ann Surg. 2004 Feb;239(2):172-81.

Split-liver transplantation in the United States: outcomes of a national

survey.

Renz JF, Emond JC, Yersiz H, Ascher NL, Busuttil RW.

Center for Liver Disease and Transplantation, New York Presbyterian

Hospital, New York, NY 10032, USA. jfr2103@...

OBJECTIVE: Assess application and outcomes of split-liver transplantation

within the United States. SUMMARY BACKGROUND DATA: While a theoretically

attractive mechanism to increase cadaver organ supply, split-liver

transplantation has been infrequently applied. The American Society of

Transplant Surgeons, in an attempt to gather preliminary data on split-liver

transplantation, performed a data protected survey of transplant centers

participating in the U.S. Scientific Registry for Transplant Recipients.

METHODS: Between April 2000 and May 2001, 89 surgical teams were surveyed.

Elicited data included graft type, recipient status, procurement method,

graft sharing, graft outcomes, recipient outcomes, and experience with

cadaver, whole-organ transplantation. RESULTS: Eighty-three surgical teams

reported data on 207 left lateral segment, 152 right trisegment, 15 left

lobe, and 13 right lobe grafts. The split procedure was performed ex vivo in

54% and in situ in 46% of grafts. Complications were frequent in all graft

types with biliary and vascular complications equally distributed between

grafts procured by either technique. Primary nonfunction, graft failure, and

recipient death correlated with transplant status. CONCLUSIONS: Split-liver

transplantation has been principally applied to adult-child pairs with at

least one recipient critically ill. Biliary and vascular complications

account for the majority of morbidity in grafts procured by either split

technique with graft failure and recipient death observed more frequently in

critically ill recipients. Enhanced utilization and improved results may be

possible through improved information sharing and modification of allocation

criteria.

PMID: 14745324 [PubMed - indexed for MEDLINE]

[Guest guest]

Ann Surg. 2004 Feb;239(2):172-81.

Split-liver transplantation in the United States: outcomes of a national

survey.

Renz JF, Emond JC, Yersiz H, Ascher NL, Busuttil RW.

Center for Liver Disease and Transplantation, New York Presbyterian

Hospital, New York, NY 10032, USA. jfr2103@...

OBJECTIVE: Assess application and outcomes of split-liver transplantation

within the United States. SUMMARY BACKGROUND DATA: While a theoretically

attractive mechanism to increase cadaver organ supply, split-liver

transplantation has been infrequently applied. The American Society of

Transplant Surgeons, in an attempt to gather preliminary data on split-liver

transplantation, performed a data protected survey of transplant centers

participating in the U.S. Scientific Registry for Transplant Recipients.

METHODS: Between April 2000 and May 2001, 89 surgical teams were surveyed.

Elicited data included graft type, recipient status, procurement method,

graft sharing, graft outcomes, recipient outcomes, and experience with

cadaver, whole-organ transplantation. RESULTS: Eighty-three surgical teams

reported data on 207 left lateral segment, 152 right trisegment, 15 left

lobe, and 13 right lobe grafts. The split procedure was performed ex vivo in

54% and in situ in 46% of grafts. Complications were frequent in all graft

types with biliary and vascular complications equally distributed between

grafts procured by either technique. Primary nonfunction, graft failure, and

recipient death correlated with transplant status. CONCLUSIONS: Split-liver

transplantation has been principally applied to adult-child pairs with at

least one recipient critically ill. Biliary and vascular complications

account for the majority of morbidity in grafts procured by either split

technique with graft failure and recipient death observed more frequently in

critically ill recipients. Enhanced utilization and improved results may be

possible through improved information sharing and modification of allocation

criteria.

PMID: 14745324 [PubMed - indexed for MEDLINE]

[Guest guest]

Ann Surg. 2004 Feb;239(2):172-81.

Split-liver transplantation in the United States: outcomes of a national

survey.

Renz JF, Emond JC, Yersiz H, Ascher NL, Busuttil RW.

Center for Liver Disease and Transplantation, New York Presbyterian

Hospital, New York, NY 10032, USA. jfr2103@...

OBJECTIVE: Assess application and outcomes of split-liver transplantation

within the United States. SUMMARY BACKGROUND DATA: While a theoretically

attractive mechanism to increase cadaver organ supply, split-liver

transplantation has been infrequently applied. The American Society of

Transplant Surgeons, in an attempt to gather preliminary data on split-liver

transplantation, performed a data protected survey of transplant centers

participating in the U.S. Scientific Registry for Transplant Recipients.

METHODS: Between April 2000 and May 2001, 89 surgical teams were surveyed.

Elicited data included graft type, recipient status, procurement method,

graft sharing, graft outcomes, recipient outcomes, and experience with

cadaver, whole-organ transplantation. RESULTS: Eighty-three surgical teams

reported data on 207 left lateral segment, 152 right trisegment, 15 left

lobe, and 13 right lobe grafts. The split procedure was performed ex vivo in

54% and in situ in 46% of grafts. Complications were frequent in all graft

types with biliary and vascular complications equally distributed between

grafts procured by either technique. Primary nonfunction, graft failure, and

recipient death correlated with transplant status. CONCLUSIONS: Split-liver

transplantation has been principally applied to adult-child pairs with at

least one recipient critically ill. Biliary and vascular complications

account for the majority of morbidity in grafts procured by either split

technique with graft failure and recipient death observed more frequently in

critically ill recipients. Enhanced utilization and improved results may be

possible through improved information sharing and modification of allocation

criteria.

PMID: 14745324 [PubMed - indexed for MEDLINE]

[Guest guest]

Ann Surg. 2004 Feb;239(2):172-81.

Split-liver transplantation in the United States: outcomes of a national

survey.

Renz JF, Emond JC, Yersiz H, Ascher NL, Busuttil RW.

Center for Liver Disease and Transplantation, New York Presbyterian

Hospital, New York, NY 10032, USA. jfr2103@...

OBJECTIVE: Assess application and outcomes of split-liver transplantation

within the United States. SUMMARY BACKGROUND DATA: While a theoretically

attractive mechanism to increase cadaver organ supply, split-liver

transplantation has been infrequently applied. The American Society of

Transplant Surgeons, in an attempt to gather preliminary data on split-liver

transplantation, performed a data protected survey of transplant centers

participating in the U.S. Scientific Registry for Transplant Recipients.

METHODS: Between April 2000 and May 2001, 89 surgical teams were surveyed.

Elicited data included graft type, recipient status, procurement method,

graft sharing, graft outcomes, recipient outcomes, and experience with

cadaver, whole-organ transplantation. RESULTS: Eighty-three surgical teams

reported data on 207 left lateral segment, 152 right trisegment, 15 left

lobe, and 13 right lobe grafts. The split procedure was performed ex vivo in

54% and in situ in 46% of grafts. Complications were frequent in all graft

types with biliary and vascular complications equally distributed between

grafts procured by either technique. Primary nonfunction, graft failure, and

recipient death correlated with transplant status. CONCLUSIONS: Split-liver

transplantation has been principally applied to adult-child pairs with at

least one recipient critically ill. Biliary and vascular complications

account for the majority of morbidity in grafts procured by either split

technique with graft failure and recipient death observed more frequently in

critically ill recipients. Enhanced utilization and improved results may be

possible through improved information sharing and modification of allocation

criteria.

PMID: 14745324 [PubMed - indexed for MEDLINE]