Comparative study of in situ and ex situ liver splitting techniques in split liver transplantation
10.3760/cma.j.cn113855-20240602-00404
- VernacularTitle:在体与离体不同劈离方式在完全劈离式肝移植中的对比研究
- Author:
Fei FENG
1
;
Zhengwei LIN
1
;
Yingpeng YE
1
;
Hongda ZHU
1
;
Yong YANG
1
;
Caide LU
1
;
Jiongze FANG
1
Author Information
1. 宁波大学附属李惠利医院肝胆胰外科，宁波 315041
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Postoperative complications;
Adult;
Whole left and right liver
- From:
Chinese Journal of General Surgery
2025;40(2):131-138
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effect of in situ and ex situ liver splitting techniques on the short-term outcomes of complete split liver transplantation.Methods:A retrospective analysis was conducted on the perioperative and follow-up data of 81 adult split liver transplant recipients and 42 donors at Ningbo University's Affiliated Lihuili Hospital from Mar 2021 to Dec 2023. Patients were divided into the ex situ and in situ splitting groups, and short-term complications were compared.Results:As of Dec 2023, the follow-up duration ranged from 1 to 30 months, with a median of 19 months. Cold and warm ischemia times were significantly shorter in the in situ splitting group compared to the ex situ group ( P<0.001). Postoperative peak levels of AST and ALT were also lower in the in situ splitting group ( P<0.01). However, the incidence of biliary complications was higher in the in situ splitting group (13 cases vs. 1 case, P=0.028). Conclusions:Compared to ex situ splitting, in situ splitting significantly reduces cold and warm ischemia times and results in less hepatocellular injury. However, it is associated with a higher incidence of biliary complications.
