Original Articles

You have full text access to this OnlineOpen article

Extended right liver grafts obtained by an ex situ split can be used safely for primary and secondary transplantation with acceptable biliary morbidity

  1. Atsushi Takebe1,3,
  2. Harald Schrem1,
  3. Bastian Ringe1,
  4. Frank Lehner1,
  5. Christian Strassburg2,
  6. Juergen Klempnauer1,
  7. Thomas Becker1,†,*

Article first published online: 26 JUN 2009

DOI: 10.1002/lt.21745

Issue

Liver Transplantation

Liver Transplantation

Volume 15, Issue 7, pages 730–737, July 2009

Additional Information

How to Cite

Takebe, A., Schrem, H., Ringe, B., Lehner, F., Strassburg, C., Klempnauer, J. and Becker, T. (2009), Extended right liver grafts obtained by an ex situ split can be used safely for primary and secondary transplantation with acceptable biliary morbidity. Liver Transpl, 15: 730–737. doi: 10.1002/lt.21745

Author Information

  1. 1

    Department of General, Visceral, and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany

  2. 2

    Department of Gastroenterology, Hepatology, and Endocrinology, Medizinische Hochschule Hannover, Hannover, Germany

  3. 3

    Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

  1. †

    Telephone: +49-511-532-6534; FAX: +49-511-532-4010

*Department of General, Abdominal, and Transplantation Surgery, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Germany

Publication History

  1. Issue published online: 26 JUN 2009
  2. Article first published online: 26 JUN 2009
  3. Manuscript Accepted: 22 DEC 2008
  4. Manuscript Received: 28 AUG 2008

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (140K)

REFERENCES

  • 1
    Pichlmayr R, Ringe B, Gubernatis G, Hauss J, Bunzendahl H. Transplantation of a donor liver to 2 recipients (splitting transplantation)—a new method in the further development of segmental liver transplantation [in German]. Langenbecks Arch Chir 1988; 373: 127–130.
  • 2
    Renz JF, Emond JC, Yersiz H, Ascher NL, Busuttil RW. Split-liver transplantation in the United States: outcomes of a national survey. Ann Surg 2004; 239: 172–181.
  • 3
    Mirza DF, Achilleos O, Pirenne J, Buckels JA, McMaster P, Mayer AD. Encouraging results of split-liver transplantation. Br J Surg 1998; 85: 494–497.
    Direct Link:
  • 4
    Yersiz H, Renz JF, Farmer DG, Hisatake GM, McDiarmid SV, Busuttil RW. One hundred in situ split-liver transplantations: a single-center experience. Ann Surg 2003; 238: 496–505; discussion 6–7.
  • 5
    Broering DC, Mueller L, Ganschow R, Kim JS, Achilles EG, Schafer H, et al. Is there still a need for living-related liver transplantation in children? Ann Surg 2001; 234: 713–721; discussion 21–22.
  • 6
    Strong RW, Lynch SV, Ong TH, Matsunami H, Koido Y, Balderson GA. Successful liver transplantation from a living donor to her son. N Engl J Med 1990; 322: 1505–1507.
  • 7
    Busuttil RW, Goss JA. Split liver transplantation. Ann Surg 1999; 229: 313–321.
  • 8
    Greif F, Bronsther OL, Van Thiel DH, Casavilla A, Iwatsuki S, Tzakis A, et al. The incidence, timing, and management of biliary tract complications after orthotopic liver transplantation. Ann Surg 1994; 219: 40–45.
  • 9
    Pascher A, Neuhaus P. Bile duct complications after liver transplantation. Transpl Int 2005; 18: 627–642.
    Direct Link:
  • 10
    Trotter JF, Wachs M, Everson GT, Kam I. Adult-to-adult transplantation of the right hepatic lobe from a living donor. N Engl J Med 2002; 346: 1074–1082.
  • 11
    Washburn K, Halff G, Mieles L, Goldstein R, Goss JA. Split-liver transplantation: results of statewide usage of the right trisegmental graft. Am J Transplant 2005; 5: 1652–1659.
    Direct Link:
  • 12
    Wojcicki M, Silva MA, Jethwa P, Gunson B, Bramhall SR, Mayer D, et al. Biliary complications following adult right lobe ex vivo split liver transplantation. Liver Transpl 2006; 12: 839–844.
    Direct Link:
  • 13
    Corno V, Colledan M, Dezza MC, Guizzetti M, Lucianetti A, Maldini G, et al. Extended right split liver graft for primary transplantation in children and adults. Transpl Int 2006; 19: 492–499.
    Direct Link:
  • 14
    Broering DC, Topp S, Schaefer U, Fischer L, Gundlach M, Sterneck M, et al. Split liver transplantation and risk to the adult recipient: analysis using matched pairs. J Am Coll Surg 2002; 195: 648–657.
  • 15
    Wilms C, Walter J, Kaptein M, Mueller L, Lenk C, Sterneck M, et al. Long-term outcome of split liver transplantation using right extended grafts in adulthood: a matched pair analysis. Ann Surg 2006; 244: 865–872; discussion 72–73.
  • 16
    de Ville de Goyet J. Split liver transplantation in Europe—1988 to 1993. Transplantation 1995; 59: 1371–1376.
  • 17
    Adam R, McMaster P, O'Grady JG, Castaing D, Klempnauer JL, Jamieson N, et al. Evolution of liver transplantation in Europe: report of the European Liver Transplant Registry. Liver Transpl 2003; 9: 1231–1243.
    Direct Link:
  • 18
    Yan JQ, Becker T, Peng CH, Li HW, Klempnauer J. Split liver transplantation: a reliable approach to expand donor pool. Hepatobiliary Pancreat Dis Int 2005; 4: 339–344.
  • 19
    Azoulay D, Astarcioglu I, Bismuth H, Castaing D, Majno P, Adam R, et al. Split-liver transplantation. The Paul Brousse policy. Ann Surg 1996; 224: 737–746; discussion 46–48.
  • 20
    Busuttil RW, Colonna JO II, Hiatt JR, Brems JJ, el Khoury G, Goldstein LI, et al. The first 100 liver transplants at UCLA. Ann Surg 1987; 206: 387–402.
  • 21
    Sutcliffe R, Maguire D, Mroz A, Portmann B, O'Grady J, Bowles M, et al. Bile duct strictures after adult liver transplantation: a role for biliary reconstructive surgery? Liver Transpl 2004; 10: 928–934.
    Direct Link:
  • 22
    Lerut J, Gordon RD, Iwatsuki S, Esquivel CO, Todo S, Tzakis A, et al. Biliary tract complications in human orthotopic liver transplantation. Transplantation 1987; 43: 47–51.
  • 23
    Stratta RJ, Wood RP, Langnas AN, Hollins RR, Bruder KJ, Donovan JP, et al. Diagnosis and treatment of biliary tract complications after orthotopic liver transplantation. Surgery 1989; 106: 675–683; discussion 83–84.
  • 24
    Noujaim HM, Gunson B, Mayer DA, Mirza DF, Buckels JA, Candinas D, et al. Worth continuing doing ex situ liver graft splitting? A single-center analysis. Am J Transplant 2003; 3: 318–323.
    Direct Link:
  • 25
    Reichert PR, Renz JF, Rosenthal P, Bacchetti P, Lim RC, Roberts JP, et al. Biliary complications of reduced-organ liver transplantation. Liver Transpl Surg 1998; 4: 343–349.
    Direct Link:
  • 26
    Renz JF, Yersiz H, Farmer DG, Hisatake GM, Ghobrial RM, Busuttil RW. Changing faces of liver transplantation: partial-liver grafts for adults. J Hepatobiliary Pancreat Surg 2003; 10: 31–44.
  • 27
    Olthoff KM, Merion RM, Ghobrial RM, Abecassis MM, Fair JH, Fisher RA, et al. Outcomes of 385 adult-to-adult living donor liver transplant recipients: a report from the A2ALL consortium. Ann Surg 2005; 242: 314–323; discussion 23–25.
  • 28
    Malago M, Testa G, Frilling A, Nadalin S, Valentin-Gamazo C, Paul A, et al. Right living donor liver transplantation: an option for adult patients: single institution experience with 74 patients. Ann Surg 2003; 238: 853–862; discussion 62–63.
  • 29
    Schlitt HJ, Meier PN, Nashan B, Oldhafer KJ, Boeker K, Flemming P, et al. Reconstructive surgery for ischemic-type lesions at the bile duct bifurcation after liver transplantation. Ann Surg 1999; 229: 137–145.
  • 30
    Sanchez-Urdazpal L, Gores GJ, Ward EM, Maus TP, Wahlstrom HE, Moore SB, et al. Ischemic-type biliary complications after orthotopic liver transplantation. Hepatology 1992; 16: 49–53.
    Direct Link:
  • 31
    Tung BY, Kimmey MB. Biliary complications of orthotopic liver transplantation. Dig Dis 1999; 17: 133–144.
  • 32
    Colonna JO II, Shaked A, Gomes AS, Colquhoun SD, Jurim O, McDiarmid SV, et al. Biliary strictures complicating liver transplantation. Incidence, pathogenesis, management, and outcome. Ann Surg 1992; 216: 344–350; discussion 50–52.
  • 33
    Sanchez-Urdazpal L, Batts KP, Gores GJ, Moore SB, Sterioff S, Wiesner RH, et al. Increased bile duct complications in liver transplantation across the ABO barrier. Ann Surg 1993; 218: 152–158.
  • 34
    Abbasoglu O, Levy MF, Vodapally MS, Goldstein RM, Husberg BS, Gonwa TA, et al. Hepatic artery stenosis after liver transplantation—incidence, presentation, treatment, and long term outcome. Transplantation 1997; 63: 250–255.
  • 35
    Halme L, Hockerstedt K, Lautenschlager I. Cytomegalovirus infection and development of biliary complications after liver transplantation. Transplantation 2003; 75: 1853–1858.
  • 36
    Balzan S, Farges O, Sommacale D, Dondero F, Plasse M, Belghiti J. Direct bile duct visualization during the preparation of split livers. Liver Transpl 2004; 10: 703–705.
    Direct Link:
  • 37
    Goss JA, Yersiz H, Shackleton CR, Seu P, Smith CV, Markowitz JS, et al. In situ splitting of the cadaveric liver for transplantation. Transplantation 1997; 64: 871–877.
  • 38
    Miller CM, Gondolesi GE, Florman S, Matsumoto C, Munoz L, Yoshizumi T, et al. One hundred nine living donor liver transplants in adults and children: a single-center experience. Ann Surg 2001; 234: 301–311; discussion 11–12.
  • 39
    Spada M, Cescon M, Aluffi A, Zambelli M, Guizzetti M, Lucianetti A, et al. Use of extended right grafts from in situ split livers in adult liver transplantation: a comparison with whole-liver transplants. Transplant Proc 2005; 37: 1164–1166.
  • 40
    Broering DC, Wilms C, Bok P, Fischer L, Mueller L, Hillert C, et al. Evolution of donor morbidity in living related liver transplantation: a single-center analysis of 165 cases. Ann Surg 2004; 240: 1013–1024; discussions 24–26.
  • 41
    Busuttil RW, Farmer DG, Yersiz H, Hiatt JR, McDiarmid SV, Goldstein LI, et al. Analysis of long-term outcomes of 3200 liver transplantations over two decades: a single-center experience. Ann Surg 2005; 241: 905–916; discussion 16–18.
  • 42
    Kashyap R, Jain A, Reyes J, Demetris AJ, Elmagd KA, Dodson SF, et al. Causes of retransplantation after primary liver transplantation in 4000 consecutive patients: 2 to 19 years follow-up. Transplant Proc 2001; 33: 1486–1487.
  • 43
    Silva MA, Jambulingam PS, Gunson BK, Mayer D, Buckels JA, Mirza DF, et al. Hepatic artery thrombosis following orthotopic liver transplantation: a 10-year experience from a single centre in the United Kingdom. Liver Transpl 2006; 12: 146–151.
    Direct Link:
  • 44
    Stahl JE, Kreke JE, Malek FA, Schaefer AJ, Vacanti J. Consequences of cold-ischemia time on primary nonfunction and patient and graft survival in liver transplantation: a meta-analysis. PLoS ONE 2008; 3: e2468.
View Full Article (HTML) Get PDF (140K)