Ex situ splitting of the liver - The versatile Paul Brousse technique

被引:15
作者
Azoulay, D [1 ]
Marin-Hargreaves, G [1 ]
Castaing, D [1 ]
Bismuth, H [1 ]
机构
[1] Univ Paris Sud, Ctr Hepatobiliaire, Hop Paul Brousse,Assictance Publ Hop Paris, Hepatobiliary Ctr,Unite Propre Rech 1596, F-94800 Villejuif, France
关键词
D O I
10.1001/archsurg.136.8.956
中图分类号
R61 [外科手术学];
学科分类号
摘要
Split liver transplantation was introduced to alleviate the organ shortage. Comparable morbidity, graft, and patient survival rates have been reported with the use of either split or whole liver for transplantation. This article gives a detailed illustrated report of our splitting technique. Alternative techniques are also discussed. Both techniques of in situ vs ex situ splitting should be developed according to the logistical possibilities. Depending on the desired volume of the left graft, the cutting line may be shifted, particularly to the right of the middle hepatic vein, the whole of segment 4 being then included in the left graft (when thr recipients are 2 adults). Split liver transplantation increases graft availability by 15% to 28%. At present, the goal of split liver transplantation clearly has to be its clinical application in 2 adults to tackle the problem of organ shortage in this population, which accounts far more than 90% of deaths in those who are on the waiting list.
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收藏
页码:956 / 961
页数:6
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