Adult left liver transplantation from split livers and living donors: a 14-year single-center experience.
Clin Transplant
; 27(4): 571-81, 2013.
Article
en En
| MEDLINE
| ID: mdl-23786409
ABSTRACT
BACKGROUND:
In an era of organ scarcity, the use of left liver grafts for adult recipients could increase the access to liver transplantation (LT). The aim of this study was to evaluate the results in a single-center series of adult left LT over a 14-yr period. PATIENTS ANDMETHODS:
Between March 1996 and March 2010, 30 adult patients underwent LT with a left liver obtained from 16 split cadaveric livers and 14 living donors (LD). Portal vein inflow modulation was performed in selected cases.RESULTS:
A total of 19 (63.3%) grafts had early dysfunction leading to graft failure in six cases (20%). One third of the grafts developed small-for-size syndrome (SFSS). One-yr patient and graft survival was 80% and 76.7%, respectively. Regarding two successive periods, one-yr patient and graft survival dramatically increased from 62.5% to 100% (p = 0.01) and 56.2% to 100% (p = 0.002), respectively. Multivariate analysis disclosed that completion of a portosystemic shunt and the occurrence of post-operative ascites were significantly associated with graft failure.CONCLUSIONS:
Our results support that improved surgical techniques and careful patient selection can lead to a safe use of left livers for transplantation in adult recipients. Inflow modulation could be performed in very selected cases.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Trasplante de Hígado
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Fallo Hepático
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Donadores Vivos
/
Rechazo de Injerto
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Clin Transplant
Asunto de la revista:
TRANSPLANTE
Año:
2013
Tipo del documento:
Article
País de afiliación:
Francia