Boston, Mass. A new study shows that when a liver from a deceased adult or adolescent donor is split into two separate portions for transplantationwith the smaller portion going to a young child and the larger to an adultthe smaller portion used for the child will last just as long as if the child had received a whole organ from a donor close to his size.
The data, collected and analyzed by a team led by Boston Children's Hospital researchers Heung Bae Kim, MD, and Ryan Cauley, MD, MPH, was published online in Liver Transplantation, a journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. Data on graft survival and mortality for adult recipients of split livers is currently being compiled for a separate study to be released soon.
Examining pediatric data provided by the United Network of Organ Sharing (UNOS), the authors researched the mortality and graft survival of 2,679 patients under the age of two who received liver transplants between 1995-2010. Of these cases 1,114 involved partial livers and 1,565 involved whole organs. Their research indicates that from 1995- 2000 partial grafts had a higher risk of failure, but from 2000-2006 that risk was lower, indicating partial liver transplants became safer as experience with this practice increased. By 2006 both split and whole organs had similarly low rates of both graft failure and mortality, suggesting that their use could be increased to meet the demand for smaller grafts.
"Infants and young children have the highest risk of death on the liver transplant waiting list, mainly due to the shortage of appropriately sized organs," says Kim, senior author on the study and director of Boston Children's Pediatric Transplant Center. "But based on this new data, split liver transplantation may prove to be the answer to this difficult problem. If more liver donors were made available for consideration as split liver
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Boston Children's Hospital