Time for the Grown Ups to Split the Difference? Outcomes of Two Adult Split Liver Transplants in the USA.
Liver Transplant & HPB Surgery, Weill Cornell Medical College, New York, NY.
Meeting: 2016 American Transplant Congress
Abstract number: A207
Keywords: Split-liver transplantation
Session Information
Session Name: Poster Session A: Living Donor Liver Transplantation
Session Type: Poster Session
Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Background While splitting livers between children and adults has become a widely accepted practice, splitting a liver between two adults is not commonplace. This is due to fears of providing recipients with insufficient hepatic volume, and the technical challenges presented by using fully split grafts and therefore potential for worse outcome. Here we investigate the use of livers split between two adults in the United States.
Methods Analysis of UNOS Star file of adult OLTs performed between Jan 2 2002 and Sept 24 2014. Pairs of adult patients who received a whole lobar split graft were identified. We matched each split liver recipient with a whole graft recipient in order to assess outcome. One-to-one matching was performed based on recipient MELD, donor age and a diagnosis of HCV. Survival analysis was conducted using Kaplan-Meier curves. A matched pair analysis was conducted
Results A total of 33 whole livers were split between 76 adult patients throughout the study period. The majority of split recipients were female (49/76, 65%) with a mean age of 53 ± 1.8 years and a mean BMI of 24.8 ± 0.6. The median lab MELD score among this group was 18. The mean donor age was 26 ± 0.8 years. Survival in patients who received split grafts was similar to the survival of recipients of whole grafts (p=0.696 Figure 1a). There was no difference in early or late graft survival between split recipients and whole graft recipients (p=0.927, figure 1b).
Conclusion Outcomes of recipients of grafts split between 2 adults are similar to recipients of whole grafts when these patients are matched on donor age, MELD score and HCV status. Split grafts may prove to be a useful resource in an era of organ shortage for appropriately selected patients.
CITATION INFORMATION: Halazun K, Przybyszewski E, Samstein B, Verna E, Fox A, Guarrera J, Kato T, Griesemer A, Brown R, Emond J. Time for the Grown Ups to Split the Difference? Outcomes of Two Adult Split Liver Transplants in the USA. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Halazun K, Przybyszewski E, Samstein B, Verna E, Fox A, Guarrera J, Kato T, Griesemer A, Brown R, Emond J. Time for the Grown Ups to Split the Difference? Outcomes of Two Adult Split Liver Transplants in the USA. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/time-for-the-grown-ups-to-split-the-difference-outcomes-of-two-adult-split-liver-transplants-in-the-usa/. Accessed May 8, 2025.« Back to 2016 American Transplant Congress