Clinical application of split liver transplantation: a single center report of 203 cases
10.3760/cma.j.cn112139-20231225-00297
- VernacularTitle:劈离式肝移植203例临床应用
- Author:
Qing YANG
1
;
Shuhong YI
;
Binsheng FU
;
Tong ZHANG
;
Kaining ZENG
;
Xiao FENG
;
Jia YAO
;
Hui TANG
;
Hua LI
;
Jian ZHANG
;
Yingcai ZHANG
;
Huimin YI
;
Haijin LYU
;
Jianrong LIU
;
Gangjian LUO
;
Mian GE
;
Weifeng YAO
;
Fangfei REN
;
Jinfeng ZHUO
;
Hui LUO
;
Liping ZHU
;
Jie REN
;
Yan LYU
;
Kexin WANG
;
Wei LIU
;
Guihua CHEN
;
Yang YANG
Author Information
1. 中山大学附属第三医院肝脏外科暨肝移植中心 中山大学器官移植研究所 广东省器官移植研究中心 广东省移植医学工程实验室 广东省肝脏疾病研究重点实验室，广州 510630
- Keywords:
Liver transplantation;
Liver failure;
Biliary atresia;
Split liver transplantation;
Survival rate
- From:
Chinese Journal of Surgery
2024;62(4):324-330
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety and therapeutic effect of split liver transplantation (SLT) in clinical application.Methods:This is a retrospective case-series study. The clinical data of 203 consecutive SLT, 79 living donor liver transplantation (LDLT) and 1 298 whole liver transplantation (WLT) performed at the Third Affiliated Hospital of Sun Yat-sen University from July 2014 to July 2023 were retrospectively analyzed. Two hundred and three SLT liver grafts were obtained from 109 donors. One hundred and twenty-seven grafts were generated by in vitro splitting and 76 grafts were generated by in vivo splitting. There were 90 adult recipients and 113 pediatric recipients. According to time, SLT patients were divided into two groups: the early SLT group (40 cases, from July 2014 to December 2017) and the mature SLT technology group (163 cases, from January 2018 to July 2023). The survival of each group was analyzed and the main factors affecting the survival rate of SLT were analyzed. The Kaplan-Meier method and Log-rank test were used for survival analysis.Results:The cumulative survival rates at 1-, 3-, and 5-year were 74.58%, 71.47%, and 71.47% in the early SLT group, and 88.03%, 87.23%, and 87.23% in the mature SLT group, respectively. Survival rates in the mature SLT group were significantly higher than those in the early SLT group ( χ2=5.560, P=0.018). The cumulative survival rates at 1-, 3- and 5-year were 93.41%, 93.41%, 89.95% in the LDLT group and 87.38%, 81.98%, 77.04% in the WLT group, respectively. There was no significant difference among the mature SLT group, the LDLT group and the WLT group ( χ2=4.016, P=0.134). Abdominal hemorrhage, infection, primary liver graft nonfunction,and portal vein thrombosis were the main causes of early postoperative death. Conclusion:SLT can achieve results comparable to those of WLT and LDLT in mature technology liver transplant centers, but it needs to go through a certain time learning curve.
