Lau NS, Liu K, McCaughan G, Crawford M, Pulitano C. Are split liver grafts a suitable option in high-risk liver transplant recipients?
Curr Opin Organ Transplant 2021;
26:675-680. [PMID:
34653087 DOI:
10.1097/mot.0000000000000938]
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Abstract
PURPOSE OF REVIEW
To assess the outcomes of split liver transplantation (SLT) in adults and children and evaluate its role in high-risk recipients with a high model for end-stage liver disease (MELD) score, an urgent indication or requiring retransplantation.
RECENT FINDINGS
Split liver grafts in general have equivalent long-term survival outcomes to whole grafts despite an increase in biliary complications. Recent success and technical advances have encouraged use of these grafts in high-risk recipients. Split liver grafts can be used successfully in recipients with a high MELD score if there is adequate weight-matching. There are mixed results in urgent indication recipients and for retransplantation such that use in this group of patients remains controversial.
SUMMARY
SLT addresses donor shortages by facilitating the transplant of two recipients from the same donor liver. By using careful donor and recipient selection criteria, SLT can achieve equivalent long-term outcomes to whole grafts. These grafts have been used successfully in recipients with a high MELD score, but should be used selectively in urgent indication recipients and for retransplantation.
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