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The impact of intercenter sharing on the outcomes of pediatric split liver transplantation
Author(s) -
Elsabbagh Ahmed M.,
Williams Cassie,
Girlanda Raffaele,
Hawksworth Jason,
Kroemer Alexander,
Matsumoto Cal S.,
Fishbein Thomas M.
Publication year - 2017
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.13138
Subject(s) - medicine , liver transplantation , group b , retrospective cohort study , group a , organ procurement , transplantation , surgery , cohort , single center , biliary atresia , gastroenterology
Abstract Background Split liver transplantation allows for expansion of the pool of organs available for pediatric liver transplantation. The impact of sharing segments of the same liver between centers has not been studied. Study Design Retrospective analysis of 24 pediatric split liver transplant cases in a recent cohort. We evaluated the outcomes of pediatric recipients who shared organs with adult patients in our own center (group A) compared to recipients who shared organs with adult patients in other centers. (group B). Results One‐, 3‐, and 5‐year graft survival for group A was 100%, 100%, and 100% vs 83%, 71%, and 57% for group B ( P = .039). Postoperative complications included biliary complications (41.7% in group A vs 50% in group B, P = .682), vascular complications (8.3% in group A vs 41.7% in group B, P = .059), and postoperative bleeding (16.7% in group A vs 25% in group B, P = .615). High‐grade Clavien‐Dindo complications were 0% in group A vs 33.3% in group B, P = .028. Conclusions Organ sharing between centers appears to be associated with significantly poorer graft survival. Possible explanations include greater procurement‐related injury or suboptimal vessel distribution. Future larger studies focused on this area may be helpful to formulate policy considerations.