AIM: To outline the surgical experience with donor liver splitting in split liver transplantation.METHODS: From March 1 to September 1 in 2004, 10 donor livers were split ex situ into a left lateral lobe (segments ...AIM: To outline the surgical experience with donor liver splitting in split liver transplantation.METHODS: From March 1 to September 1 in 2004, 10 donor livers were split ex situ into a left lateral lobe (segments Ⅱ and Ⅲ) and a right extended lobe (segments Ⅰ, Ⅳ-Ⅷ) in Medical School of Hannover, and thereafter split liver transplantation was performed successfully in 29 cases. The average age, weight and ICU slaying period of the donors were 32.7 years (25-52 years), 64.5 kg(45-75 kg) and 2.4 d (2-8 d) respectively.RESULTS: The average weight of the whole graft and the left lateral lobe was 2 322.6 g (956-2 665 g) and 282.8 g (298-373 g) respectively, and the average ratio of left lateral lobe to the whole graft was 0.225 (0.278-0.274).The average graft to recipient weight ratio (GRWR) of the left lateral lobe and the right extended lobe reached 2.44% (2.22-5.42%) and 2.73% (2.32-2.30%) respectively.On average it took approximately 205 min (85-235 rain)to split the donor liver. Five donor organs showed anatomic variation including the left hepatic vein variation in two cases, the left hepatic artery variation in two cases and the bile duct variation in one case.CONCLUSION: Split liver transplantation has become a mature surgical technique to expand the donor pool with promising results. In the process of graft splitting, close attention needs to be paid to potential anatomic variations,especially to variations of the left hepatic vein, the left hepatic artery, and the bile duct.展开更多
文摘AIM: To outline the surgical experience with donor liver splitting in split liver transplantation.METHODS: From March 1 to September 1 in 2004, 10 donor livers were split ex situ into a left lateral lobe (segments Ⅱ and Ⅲ) and a right extended lobe (segments Ⅰ, Ⅳ-Ⅷ) in Medical School of Hannover, and thereafter split liver transplantation was performed successfully in 29 cases. The average age, weight and ICU slaying period of the donors were 32.7 years (25-52 years), 64.5 kg(45-75 kg) and 2.4 d (2-8 d) respectively.RESULTS: The average weight of the whole graft and the left lateral lobe was 2 322.6 g (956-2 665 g) and 282.8 g (298-373 g) respectively, and the average ratio of left lateral lobe to the whole graft was 0.225 (0.278-0.274).The average graft to recipient weight ratio (GRWR) of the left lateral lobe and the right extended lobe reached 2.44% (2.22-5.42%) and 2.73% (2.32-2.30%) respectively.On average it took approximately 205 min (85-235 rain)to split the donor liver. Five donor organs showed anatomic variation including the left hepatic vein variation in two cases, the left hepatic artery variation in two cases and the bile duct variation in one case.CONCLUSION: Split liver transplantation has become a mature surgical technique to expand the donor pool with promising results. In the process of graft splitting, close attention needs to be paid to potential anatomic variations,especially to variations of the left hepatic vein, the left hepatic artery, and the bile duct.