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Adult left liver transplantation from split livers and living donors: a 14‐year single‐center experience
Author(s) -
Boillot Olivier,
Sagnard Pierre,
Guillaud Olivier,
Ber CharlesEric,
Pouyet Michel,
Dumortier Jérôme
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12162
Subject(s) - medicine , single center , liver transplantation , cadaveric spasm , surgery , ascites , transplantation
Background In an era of organ scarcity, the use of left liver grafts for adult recipients could increase the access to liver transplantation ( LT ). The aim of this study was to evaluate the results in a single‐center series of adult left LT over a 14‐yr period. Patients and methods Between March 1996 and March 2010, 30 adult patients underwent LT with a left liver obtained from 16 split cadaveric livers and 14 living donors ( LD ). Portal vein inflow modulation was performed in selected cases. Results A total of 19 (63.3%) grafts had early dysfunction leading to graft failure in six cases (20%). One third of the grafts developed small‐for‐size syndrome ( SFSS ). One‐yr patient and graft survival was 80% and 76.7%, respectively. Regarding two successive periods, one‐yr patient and graft survival dramatically increased from 62.5% to 100% (p = 0.01) and 56.2% to 100% (p = 0.002), respectively. Multivariate analysis disclosed that completion of a portosystemic shunt and the occurrence of post‐operative ascites were significantly associated with graft failure. Conclusions Our results support that improved surgical techniques and careful patient selection can lead to a safe use of left livers for transplantation in adult recipients. Inflow modulation could be performed in very selected cases.