Right Extended Split Liver Transplantation Compared With Whole Liver Transplantation: Lessons Learned at a Single Center in Latin America—Results From a Match Case-Control Study

DESCALZI, V.; RAMISCH, D.; PEDRAZA, N.; GONDOLESI, G.E.; RUMBO, C.; MOULIN, L.; GAMBARO, S.E.; BARROS-SCHELOTTO, P.; YANTORNO, S.; ROMERO, P.

TRANSPLANTATION PROCEEDINGS

ELSEVIER SCIENCE INC

Año: 2017 vol. 49 p. 2122 - 2128

0041-1345

Background. Despite the progressively increasing gap between patients waiting for livertransplant under the Model for End-stage Liver Disease MELD system and the availabilityof deceased donor organs, the use of right extended split liver grafts (RESLG) has not beenaccepted by all centers. In this study, we compared the results obtained using RESLG vs agroup of matched whole liver graft (WLG) recipients at a single center in Latin America.Methods. A single-center retrospective review performed between August 2009 andDecember 2015.Results. Fifteen RESLGs were implanted to recipients between 13 and 70 years of age;80% were performed ex situ. The ? biological MELD ? score for the RESLG group was 17.5 5.6, and it was 12.8 4.5 for the WLG group ( P ¼ .01). Cold ischemia times weresigni fi cantly longer in RESLG recipients compared with WLG recipients (528 minutes vs420 minutes; P < .01). No signi fi cant differences were found in biliary (leak or stricturesP ¼ .40) and arterial complications (hepatic artery thrombosis, P ¼ .06). RESLG patientsbene fi ted from a considerable reduction on their waiting time in list. The 1-, 3-, and 5-yearpatient survival rates were 93%, 93%, and 93% respectively, for RESLG recipients vs100%, 95.7%, and 86.1%, respectively, for WLG recipients. The 1-, 3-, and 5-year graftsurvival rates were 79.4%, 79.4%, and 79.4% for RESLG recipients and 89.7%, 89.7%,and 89.7% for WLG recipients, respectively. No statistical differences were observed.Conclusion. RESLG allows expeditious transplantation for low MELD recipients. Its useshould be expanded in Latin America and worldwide as a valid alternative to increase thedonor pool as it has been used in other regions.