Ann Liver Transplant.  2022 Nov;2(2):112-116. 10.52604/alt.22.0023.

Split liver transplantation for one adult and one pediatric recipient: A collective review of Korean experience

• Park CS
• Park JI

• KMID: 2560904
• DOI: http://doi.org/10.52604/alt.22.0023

Abstract

Split liver transplantation (SLT) was developed to increase the number of donor graft livers used for liver transplantation. In conventional SLT, the liver of the deceased donor is divided into two parts, the left lateral section for pediatric recipients and the extended right liver graft for adult recipients. This review presents the Korean experience of SLT for adult and pediatric recipients to delineate the characteristics of SLT. An analysis of the multicenter experience using the Korean Network for Organ Sharing data revealed that a sufficient volume of the graft estimated from donor-to-recipient weight ratio-matching could lead to better outcomes of adult SLTs with an extended right liver graft. A single-center experience of SLT on adult recipients presented that survival outcomes were similar in adult SLT and whole liver transplantation recipients, probably due to selection of high-quality grafts and low-risk recipients. An analysis of the Korean multi-center experience on pediatric recipients presented that the graft and overall survival rates of SLT and living donor liver transplantation were not different in pediatric patients, and that fulminant hepatic failure was the only risk factor affecting graft survival outcome. In conclusion, this collective review demonstrated that survival outcomes were comparable between adult SLT and whole liver transplantation recipients as well as pediatric SLT and living donor liver transplantation. Judicious selection of donors and adult recipients for SLT might expand the liver graft pool for pediatric patients without affecting adult recipients undergoing SLT.

Keyword

Deceased donor; Liver transplantation; Liver splitting; Pediatric recipient; Left lateral section graft