Lauterio A, Di Sandro S, Concone G, De Carlis R, Giacomoni A, De Carlis L. Current status and perspectives in split liver transplantation. World J Gastroenterol 2015; 21(39): 11003-11015 [PMID: 26494957 DOI: 10.3748/wjg.v21.i39.11003]
Corresponding Author of This Article
Andrea Lauterio, MD, FEBS, Transplant Center, Department of General Surgery and Abdominal Transplantation, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. andrea.lauterio@ospedaleniguarda.it
Research Domain of This Article
Transplantation
Article-Type of This Article
Topic Highlight
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 21, 2015; 21(39): 11003-11015 Published online Oct 21, 2015. doi: 10.3748/wjg.v21.i39.11003
Current status and perspectives in split liver transplantation
Andrea Lauterio, Stefano Di Sandro, Giacomo Concone, Riccardo De Carlis, Alessandro Giacomoni, Luciano De Carlis
Andrea Lauterio, Stefano Di Sandro, Giacomo Concone, Riccardo De Carlis, Alessandro Giacomoni, Luciano De Carlis, Transplant Center, Department of General Surgery and Abdominal Transplantation, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
Stefano Di Sandro, Giacomo Concone, Riccardo De Carlis, Department of General Surgery, University of Pavia Medical School, 27100 Pavia, Italy
Author contributions: Lauterio A drafted the article critically for important intellectual content; Di Sandro S, Concone G, De Carlis R and Giacomoni A gave substantial contributions to concept and design of the article, acquisition of data, and interpretation of data; Lauterio A and De Carlis L gave the final approval of the version to be published.
Conflict-of-interest statement: The authors listed have NO financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Andrea Lauterio, MD, FEBS, Transplant Center, Department of General Surgery and Abdominal Transplantation, Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. andrea.lauterio@ospedaleniguarda.it
Telephone: +39-02-64442252 Fax: +39-2-64442893
Received: April 28, 2015 Peer-review started: May 6, 2015 First decision: June 2, 2015 Revised: June 27, 2015 Accepted: August 30, 2015 Article in press: August 30, 2015 Published online: October 21, 2015
Abstract
Growing experience with the liver splitting technique and favorable results equivalent to those of whole liver transplant have led to wider application of split liver transplantation (SLT) for adult and pediatric recipients in the last decade. Conversely, SLT for two adult recipients remains a challenging surgical procedure and outcomes have yet to improve. Differences in organ shortages together with religious and ethical issues related to cadaveric organ donation have had an impact on the worldwide distribution of SLT. Despite technical refinements and a better understanding of the complex liver anatomy, SLT remains a technically and logistically demanding surgical procedure. This article reviews the surgical and clinical advances in this field of liver transplantation focusing on the role of SLT and the issues that may lead a further expansion of this complex surgical procedure.
Core tip: The transplantation community has made numerous efforts to expand the donor pool. While conventional split liver transplantation in which a child received the left lateral segment and an adult the right liver has proved an effective approach to increase organ availability, current outcomes after split liver transplantation for two adult recipients are conflicting. Ongoing surgical refinements and innovations have been reported and dedicated organ allocation policies proposed to encourage the more widespread application of this challenging procedure in the future.
