Navigation Links
Experts examine challenges of split liver transplantation
Date:6/30/2008

Can split liver transplantation reliably yield grafts for two adults? Experts consider this question alongside new findings about the procedure in the July issue of Liver Transplantation, a journal by John Wiley & Sons. The articles are also available online at Wiley Interscience (www.interscience.wiley.com).

The shortage of donor organs has led to advanced surgical strategies to increase opportunities for those in need of a transplant. An example is the split liver transplant (SLT), in which one donated liver is divided into the larger right hemisphere and the smaller left hemisphere, and the two halves are transplanted into two different patients. Recipients are typically one adult and one child, to account for the differing sizes of the grafts; and there has been scarce data on SLT involving two adult recipients.

Researchers led by Alessandro Giacomoni of Niguarda Hospital in Milan, Italy, report on a series of 16 SLTs with adult recipients that took place between May 1999 and December 2006. They report a discouraging rate of complications, and a 1-year survival of 69 percent, which was considerably lower than the 87 percent survival for their control group of whole liver transplant recipients.

"SLT for two adult recipients is a technically demanding procedure, which requires complex logistics and very experienced surgical teams both in liver resection and transplantation but yielding results debatable at best," they conclude. "Strong refinements in donor-recipient matching, preoperative donor evaluation, and surgical technique might be the tools to improve the outcome."

In a different article in the same issue, researchers led by Nigel Heaton of London, suggest another approach to SLT. They point out that a lack of cadaveric donation has led doctors to pioneer the simultaneous transplant of two left liver sections from living donors. "The technique is practicable and has been associated with good outcome," they report. "Even if one of the grafts fails over time, the remaining graft hypertrophies and takes over function."

They suggest a new technique utilizing two left liver sections from two cadaveric donors, or the combination of a cadaveric left liver with one from a living donor as a way to help more patients in need of a transplant. "This would require significant infrastructure, logistical and organizational change," they say, but believe it could increase the number of transplants by 15 to 20 percent in the U.K.

In an editorial, Cristiano Quintini and colleagues at the Cleveland Clinic, contribute their experience with eight SLTs with two adult recipients. By combining technical refinements with an extensive learning curve, they were able to minimize graft failure and avoid patient death. "We continue to believe that adult/adult split liver transplantation is a viable option in highly selected situations," they report, while noting the promise in the dual graft technique suggested by Heaton, in spite of its practical difficulties.

"We look forward to a time when both SLT and living donation, separately or in tandem, have transitioned from an 'embryonic' phase into a routine and effective way of reducing the organ shortage," they conclude.


'/>"/>

Contact: Sean Wagner
swagner@wiley.com
781-388-8550
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Research Links TV/Video Game Playing With Child Obesity; Health Experts Back a New Approach
2. MultiVu Video Feed: PUBLIC HEALTH EXPERTS CONVENE TO DISCUSS THE TREATMENT AND PREVENTION OF RABIES
3. Health IT Event Draws Experts to the Pacific Northwest
4. Experts Sort Out Good Fats From Bad
5. Experts Offer Tips on Lung Cancer Prevention
6. March of Dimes, Experts for Moms and Babies, Launches Podcast
7. World fertility experts to meet in Montreal - IVF and IVM patients to provide first-person accounts at 14th World Congress
8. Bay IVF Experts Launch One of First East-West Fertility Programs of Its Kind
9. Experts propose cholesterol tests at 15 months of age
10. Experts Publish New Lung Disease Guidelines
11. Experts, Advocates Available to Comment on Hillary Clintons Health Care Plan
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... TX (PRWEB) , ... June 25, 2016 , ... Austin ... of the American College of Mohs Surgery and to Dr. Russell Peckham for medical ... and highly effective treatment for skin cancer. The selective fellowship in Mohs Micrographic Surgery ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... recover from injury. Recently, he has implemented orthobiologic procedures as a method for ... is one of the first doctors to perform the treatment. Orthobiologics are substances ...
(Date:6/24/2016)... ... June 24, 2016 , ... June 19, 2016 is World Sickle ... chronic pain and the benefits of holistic treatments, Serenity Recovery Center of ... Sickle Cell Disease. , Sickle Cell Disease (SCD) is a disorder of the red ...
(Date:6/24/2016)... CA (PRWEB) , ... June 24, 2016 , ... Comfort ... the American Cancer Society and the Road To Recovery® program to drive cancer patients ... seniors and other adults to ensure the highest quality of life and ongoing independence. ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Grove Investment Group (TGIG), has initiated cultivation and processing operations at its production ... and Pahrump, Nevada. , Puradigm is the manufacturer of a complete system of ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Capricor Therapeutics, Inc. ... company focused on the discovery, development and commercialization ... in its ongoing randomized HOPE-Duchenne clinical trial (Halt ... its 24-patient target. Capricor expects the trial to ... 2016, and to report top line data from ...
(Date:6/23/2016)... 2016  Astellas today announced the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations headquartered in ... America . ... ... ... ...
(Date:6/23/2016)... 23, 2016  Experian Health, the healthcare ... the patient payment and care experience, today ... products and services that will enhance the ... offerings. These award-winning solutions will enable healthcare ... compliant in an ever-changing environment and redefine ...
Breaking Medicine Technology: