Background: Split liver transplantation allows for expansion of the pool of organs for pediatric liver transplantation.

Objectives: To assess overall outcomes in pediatric split liver transplantation and investigate if organ sharing with other institutes affects these outcomes.

Design: Single-center retrospective analysis of twenty four pediatric split liver transplant cases in period between January, 2006 and December, 2014. We identified two groups: group A (those who shared organs with patients in our institute) and group B (those who shared organs with patients in other institutes)

Results: Median age of our patients was 1.91 (Range: 0.45-10.61) year. 58.3% of them were female. Group A included 50% of the patients.

1-, 3-, and 5-year overall patient survival was 100%, 100% and 96%, respectively while overall graft survival was 92%, 85%, and 78%, respectively. 1-, 3-, and 5-year patient survival for group A was 100%, 100%, and 100% versus 92%, 92%, and 92% for group B (P= 0.317 ). 1-, 3-, and 5-year graft survival for group A was 100%, 100%, and 100% versus 83%, 71%, and 57% for group B (P= 0.039 ).

Postoperative complications included biliary complications (31.7% in group A vs 40% in group B), vascular flow complications ( 8.3% in group A vs 33.3% in group B), postoperative bleeding (16.7% in group A vs 25% in group B), graft dysfunction (0% in group A vs 16.7% in group B).

Conclusions: Split liver transplantation is an excellent way to expand the deceased donor pool for pediatric populations. Organ sharing between centers had significant poorer graft survival outcomes than organ sharing in between patients in the same center. Future larger studies are warranted to investigate this which may change the organ allocation policy.

CITATION INFORMATION: Elsabbagh A, Williams C, Girlanda R, Desai C, Hawksworth J, Kroemer A, Matsumoto C, Fishbein T. Pediatric Split Liver Transplantation: Single Center Experience. Am J Transplant. 2016;16 (suppl 3).

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