11 research outputs found
Hepatic artery flow and cardiac output: correlation between systemic and liver hemodynamics
status: publishe
Postreperfusion portal inflow correlates with early graft loss following liver transplantation with whole organs. A hemodynamic evaluation of 338 consecutive transplants
Early graft function and outcome correlates with postreperfusion portal inflow: A hemodynamic evaluation of 364 consecutive liver transplants
Early retransplantation rate is consistently higher in non-heart-beating donor liver transplantation and independent from the recipient status
Clinical impact of obesity (BMI >= 30) after liver transplantation. A single institutional experience
Improved results for adult split liver transplantation with extended right lobe grafts: could we enhance its application?
Objective. Split liver transplantation (SLT) allows grafting of 2 recipients with I allograft. Results of adult SLT have improved since its first introduction. Children benefit most from SLT, while among some adult liver transplanters there are concerns about splitting a liver, turning a good quality graft into a marginal one. We performed a single center retrospective review to address this issue.
Patients and Methods. Between June 2001 and August 2008, we performed 22 extended right liver graft (eRLG) transplantations in 21 adult patients.
Results. Eleven donors (50%) did not meet the Eurotransplant criteria for optimal donors. Forty-one percent of eRLG donors showed hemodynamic instability at the time of harvest. Eighteen (82%) splitting procedures were performed ex situ. The main indications for transplantation were alcoholic liver cirrhosis (32%), hepatitis C-related cirrhosis (18%), and acute liver failure (18%). Mean recipient age was 54 years (range, 17-69 years); median Model for End-Stage Liver Disease (MELD) score was 15 (range, 7-40). Patients were followed for a median of 16 months (range, 4-92 months) following transplantation. We observed 5 (23%) vascular and 3 (14%) biliary complications. Overall patient survival was 84% at 3 years; overall graft survival was 79%. For the 11 patients who had undergone transplantation after 2007, we observed a 100% patient and graft survival.
Conclusion. After an initial learning curve and provided careful selection, exceptions to classical donor criteria for splitting can be accepted with successful outcomes comparable to those after whole liver transplantation