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Long‐term follow‐up after full‐split liver transplantation and its applicability in the recent transplant era
Author(s) -
Herden Uta,
Fischer Lutz,
Sterneck Martina,
Grabhorn Enke,
Nashan Bjoern
Publication year - 2018
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.13205
Subject(s) - medicine , liver transplantation , surgery , retrospective cohort study , transplantation , waiting list
Full‐split liver transplantation ( LTX ) offers the possibility to expand the donor pool by utilization of one liver for two adults. The aim of our study was to analyze the long‐term outcome in a large series and its applicability in the recent transplant era. Methods We performed a retrospective analysis of all full‐split LTX from deceased donors (1999‐2015). Additionally, the potential of full‐split LTX was retrospectively analyzed in all whole organ LTX recipients between 2006 and 2015 (after introduction of the MELD allocation). Results We performed 44 full‐split LTX , thereof 82% before introduction of the MELD ‐based allocation system in Germany. Analysis showed highly selected recipients (median MELD score 8 points) and organ data (median donor age 30 years). 5‐ and 10‐year patient survival rates after full‐left and full‐right LTX were 90.7%/90.7% and 85.2%/56.8% ( P = .301), corresponding graft survival rates were 80.5%/80.5% in full‐left grafts and 73.7%/36.8% in full‐right graft ( P = .198). Conclusion In the past, in case of strict donor and recipient selection, full‐split LTX was a feasible method with a good outcome. Due to introduction of the national waiting list with a patient‐oriented allocation based on the MELD score in 2006, full‐split LTX seems to be not any longer applicable.