Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1691
Revised: May 1, 2024
Accepted: May 21, 2024
Published online: June 27, 2024
Processing time: 124 Days and 18.5 Hours
Given the current organ shortage crisis, split liver transplantation (SLT) has emerged as a promising alternative for select end-stage liver disease patients.
To introduce an ex-vivo liver graft splitting approach and evaluate its safety and feasibility in SLT.
A retrospective analysis was conducted on the liver transplantation data from cases performed at our center between April 1, 2022, and May 31, 2023. The study included 25 SLT cases and 81 whole liver transplantation (WLT) cases. Total ex-vivo liver splitting was employed for SLT graft procurement in three steps. Patient outcomes were determined, including liver function parameters, postoperative complications, and perioperative mortality. Group comparisons for categorical variables were performed using the χ²-test.
In the study, postoperative complications in the 25 SLT cases included hepatic artery thrombosis (n = 1) and pulmonary infections (n = 3), with no perioperative mortality. In contrast, among the 81 patients who underwent WLT, complications included perioperative mortality (n = 1), postoperative pulmonary infections
Our findings suggest that the total ex-vivo liver graft splitting technique is a safe and feasible approach, especially under the expertise of an experienced transplant center. The approach developed by our center can serve as a valuable reference for other transplantation centers.
Core Tip: Split liver transplantation has become a routine procedure at many transplant centers, and there are currently two main approaches for the generation of split-liver allografts: In-situ splitting and ex-vivo splitting. While in-situ splitting, which involves liver division within the organ donor’s body before procurement, is the prevailing technique adopted by most transplant centers, the utilization of ex-vivo splitting, wherein the liver is divided after procurement, remains limited. Our findings suggest that the ex-vivo liver graft splitting technique is a safe and feasible approach, especially under the expertise of an experienced transplant center.