Split liver transplantation: Current developments

Table 1 Recently published formulae to calculate the liver volume

Ref.	Formula	Patient group	Technique
Urata et al[20], 1995	LV (mL) = 706.2 × BSA (m2) + 2.4	96 patients (65 pediatric)	CT
Vauthey et al[21], 2002	Based on BSA:	292 adults	CT
	LV = -794.41 + 1267.28 × BSA (m2)
	r2 = 0.46; P < 0.0001
	Based on patient weight:
	LV = 191.80 + 18.51 × body weight (kg)
	r2 = 0.49; P < 0.0001
Heinemann et al[17], 1999	LV (mL) = 1072.8 × BSA (m2) - 345.7	1332 patients	Autopsy
Kokudo et al[19], 2015	LV = 203.3 - (3.61 × age) + [58.7 × thoracic width (cm)] - [463.7 × race (1 = Asian, 0 = Caucasian)]	180 Japanese and 160 Swiss patients	CT
Herden et al[18], 2013	Children 0 to ≤ 1 yr:	388 pediatrics	Autopsy
	LV (mL) = 143.062973 + 4.274603051 × body length (cm) + 14.78817631 × body weight (kg)
	Children > 1 yr to < 16 yr:
	LV (mL) = 20.2472281 + 3.339056437 × body length (cm) + 13.11312561 × body weight (kg)

LV: Liver volume; BSA: Body surface area; CT: Computed tomography.

Table 2 Criteria and rates of split liver transplantation in different transplant programs according to the transplant programs homepages

Program	Rate of SLT	Donor age	Weight/BMI	Transaminases	Other criteria
UNOS	1%-4% (but according to UNOS criteria > 10% eligible)	< 40	< 28 kg/m2	< 3 × ULN	Single vasopressor
ET	6%	< 50	> 50 kg
United Kingdom	10.6%	< 40	> 50 kg		< 5 d ICU
Argentina/Brazil	10%	< 47	umbilical perimeter < 92 cm	AST < 42 U/L
				ALT < 29 U/L
Oceania	6%
Scandia-transplant	?	< 51	< 26 kg/m2	ALT/AST < 3 × normal	< 4 d ICU
Saudi-Arabia	5.6%
South Africa	3%
Japan	1.8%
Italy	8% (Northern Italy: 20%)	< 60		Near-normal liver function tests	< 5 d ICU Low inotropic support

ALT: Alanine transaminase; AST: Aspartate aminotransferase; ET: Eurotransplant; ICU: Intensive care unit; SLT: Split liver transplantation.

Table 3 Numbers of liver transplantations, living-donor liver transplantations, deceased donor liver transplantations, and split liver transplantations and the rate of split liver transplantation in deceased donor liver transplantation performed in different transplant programs in 2016 according to the International Registry in Organ Donation and Transplantation

	Total number	Living donors	Deceased donors	Split-liver	Split-liver (%)
UNOS	8082	367	7715	0	0
Eurotransplant
Germany	821	61	760	74	9.01
Austria	154	2	152	6	3.90
Croatia	121	0	121	0	0
Netherlands	147	0	147	0	0
Belgium	302	46	256	1	0.33
Luxemburg	0	0	0	0	0
Hungary	74	0	74	0	0
Slovenia	27	0	27	0	0
Scandiatransplant	0
Sweden	199	2	197	0	0
Norway	100	0	100	0	0
Finland	61	0	61	0	0
Iceland	0	0	0	0	0
Denmark	57	0	57	0	0
China	-	-	-	-
India	-	-	-	-
Japan	438	381	57	8	1.83
South Korea	1473	965	508	36	2.44
Australia	314	2	312	65	20.70
Brazil	2037	157	1880	0	0
Argentina	349	37	312	0	0
Mexico	178	3	175	0	0
Canada	582	73	509	0	0
South Africa	69	15	54	2	2.90
United Kingdom	953	32	921	101	10.60
France	1317	5	1312	0	0
Spain	1159	28	1131	0	0
Italy	1220	7	1213	98	8.03
Poland	345	28	317	0	0
Czech Republic	179	1	178	0	0
Balttransplant	33	0	33	0	0