Adult Deceased Donor Liver Transplantation with Split Liver Grafts vs Whole Liver Grafts. A Single-Center Experience

P. Vargas¹, C. Argo², H. Zachary², M. Stotts², N. Intagliata², P. Northup², S. Pelletier¹, J. Oberholzer¹, N. Goldaracena¹

¹Transplant Surgery, University of Virginia Health System, Charlottesville, VA, ²Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, VA

Meeting: 2021 American Transplant Congress

Abstract number: 1132

Keywords: Liver grafts, Liver transplantation, Outcome, Split-liver transplantation

Topic: Clinical Science » Liver » Liver: Living Donor Liver Transplant and Partial Grafts

Session Information

Session Name: Liver: Living Donor Liver Transplant and Partial Grafts

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: The present study aims to report outcomes of adults following SLT in a single-center and compare this selected group with adults recipients following whole liver transplantation.

*Methods: Between 2010 and 2019, SLT conducted at a single-center were identified retrospectively by electronic medical records review. A 1:1 case-control match was performed to match patients following split liver transplant and adult patients receiving a whole liver graft in the same period. The random match analysis was based on recipient age (±10 years), MELD (±5 points), and indication for transplant. Demographic variables, surgical variables, postoperative outcomes and long-term complications in the two groups of patients were compared.

*Results: Twenty-one SLT were performed during the study period (SLT group) and 21 adults receiving a whole liver (WL group) were randomly generated. The median (IQR) age at transplant was 59 (49-63) for the SLT group and 59 (52-64) for the WL group (p=0.35). Recipient male gender proportion was higher, but not statistically different, in the WL group (52.4% vs 38.1% respectively;p=0.35). Recipient BMI (SLT=25.4 (23.8-28.2) vs WL=28 (23.8-32.7); p=0.11) and MELD (SLT= 23 (16-27) vs. WL= 25 (16.5-28); p=0.95) at transplant were similar between groups. The most common indication for liver transplant was Alcohol induced cirrhosis found in 7 (33.3%) recipients, followed by HCV cirrhosis in 4 (19%) and NASH in 3 (14.3%) recipients in both groups. Donor age (WL= 47 (33.5-66) vs. SLT= 16 (15-22) years, p=<0.001) and donor BMI (WL= 25.5 (21.3-31.2) vs SLT= 22.9 (20-24.7), p=<0.002) were significantly higher in the WL group compared to SLT group. Length of stay, ICU stay and readmission within 30 days post-transplant were similar between both groups. Re-transplantation occurred in one (4.8%) patient in the SLT group. This consisted of a patient who received a right lobe split liver and subsequently developed HAT within the first 7 days after LT. No recipients in the WL group were re-transplanted. No mortality occurred in neither of the groups. Graft survival at 1-, 3- and 5- year were similar between groups (100% vs 95% for all time periods, p=0.31). Patient survival at 1-, 3- and 5- year were 100% in both groups.

*Conclusions: SLT represents a feasible option to expand the donor pool with favorable outcomes in well-selected adult recipients.

To cite this abstract in AMA style:

Vargas P, Argo C, Zachary H, Stotts M, Intagliata N, Northup P, Pelletier S, Oberholzer J, Goldaracena N. Adult Deceased Donor Liver Transplantation with Split Liver Grafts vs Whole Liver Grafts. A Single-Center Experience [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/adult-deceased-donor-liver-transplantation-with-split-liver-grafts-vs-whole-liver-grafts-a-single-center-experience/. Accessed November 21, 2024.

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