How to apply ex-vivo split liver transplantation safely and feasibly: A three-step approach

Zhao, Dong1,2; Xie, Qiu-Hua3; Fang, Tai-Shi1,2; Zhang, Kang-Jun1,2; Tang, Jian-Xin1,2; Yan, Xu1,2; Jin, Xin1,2; Xie, Lin-Jie1,2; Xie, Wen-Gui3

2024-06-27

10.4240/wjgs.v16.i6.1691

WORLD JOURNAL OF GASTROINTESTINAL SURGERY   影响因子和分区

1948-9366

BACKGROUND Given the current organ shortage crisis, split liver transplantation (SLT) has emerged as a promising alternative for select end-stage liver disease patients. AIM To introduce an ex-vivo liver graft splitting approach and evaluate its safety and feasibility in SLT. METHODS 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 chi(2)-test. RESULTS 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 (n = 8), abdominal infection (n = 1), hepatic artery thromboses (n = 3), portal vein thrombosis (n = 1), and intra-abdominal bleeding (n = 5). Comparative analysis demonstrated significant differences in alanine aminotransferase (176.0 vs 73.5, P = 0.000) and aspartate aminotransferase (AST) (42.0 vs 29.0, P = 0.004) at 1 wk postoperatively, and in total bilirubin (11.8 vs 20.8, P = 0.003) and AST (41.5 vs 26.0, P = 0.014) at 2 wk postoperatively. However, the overall incidence of complications was comparable between the two groups (P > 0.05). CONCLUSION 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.

Split liver transplantation Transplantation Liver splitting Ex-vivo In-situ

SCI

英语

第一 ; 通讯

Shenzhen Science and Technology Research and Development Fund[JCYJ20220530163011026]

Gastroenterology & Hepatology ; Surgery

Gastroenterology & Hepatology ; Surgery

WOS:001267244800018

BAISHIDENG PUBLISHING GROUP INC

Web of Science

1.Southern Univ Sci & Technol, Shenzhen Peoples Hosp 3, Affiliated Hosp 2, Dept Liver Surg,Sch Med, 29 Bulan Rd, Shenzhen 518112, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Shenzhen Peoples Hosp 3, Affiliated Hosp 2, Organ Transplantat Ctr,Sch Med, 29 Bulan Rd, Shenzhen 518112, Guangdong, Peoples R China
3.Southern Univ Sci & Technol, Shenzhen Peoples Hosp 3, Affiliated Hosp 2, Dept Organ Procurement Org,Sch Med, Shenzhen 518112, Guangdong, Peoples R China

Zhao, Dong,Xie, Qiu-Hua,Fang, Tai-Shi,et al. How to apply ex-vivo split liver transplantation safely and feasibly: A three-step approach[J]. WORLD JOURNAL OF GASTROINTESTINAL SURGERY,2024,16(6).

Zhao, Dong.,Xie, Qiu-Hua.,Fang, Tai-Shi.,Zhang, Kang-Jun.,Tang, Jian-Xin.,...&Xie, Wen-Gui.(2024).How to apply ex-vivo split liver transplantation safely and feasibly: A three-step approach.WORLD JOURNAL OF GASTROINTESTINAL SURGERY,16(6).

Zhao, Dong,et al."How to apply ex-vivo split liver transplantation safely and feasibly: A three-step approach".WORLD JOURNAL OF GASTROINTESTINAL SURGERY 16.6(2024).