Split liver transplantation: Theoretical and practical aspects

by X. Rogiers (Editor), H. Bismuth (Editor), R.W. Busuttil (Editor), D.C. Broering (Editor), D. Azoulay (Editor)

Overview

The last decade has seen an explosion in the surgical efforts to overcome the shortage of liver grafts for transplantation. The end of the 1990s saw the development of the concepts of reduced, split and living donor transplantation by the transplant pioneers and their first applications in practice. During the 1990s many centers throughout the world invested their experience to further develop this into safe and teachable standardized procedures with excellent results. The result of this development is not only that split liver transplantation between adults and children became a validated surgical technique, but also the real possibility of achieving 0% mortality for children on the waiting list today. However, like many new surgical techniques, its success does not only depend on adequate patient selection (in this case selection of the donor and the recipients!), but also on the avoidance of mis­ takes that were already experienced by previous surgeons. It is this principle, combined with the need of spreading split liver trans­ plantation knowledge, that led to the organization of the first prac­ tical split liver transplantation course in Hamburg in March 2000. Writing about the surgeon scientist, Joseph E. Murray de­ scribed one of the differences between the scientist and sur­ geon: « The scientist can wait for all the data to become avail­ able whereas the surgeon must make a decision based on avail­ able data." This book aims to provide the surgeon, who wants to start split liver transplantation with the data available today.

Product Details

ISBN-13:	9783798512566
Publisher:	Springer-Verlag New York, LLC
Publication date:	10/03/2002
Pages:	158
Product dimensions:	6.10(w) x 9.25(h) x 0.02(d)

Table of Contents

1.1 History of split liver transplantation.- 1.2 Split liver transplantation: what has been done and where is the need.- 1.3 Logistic aspects and procedures in split liver transplantation.- 1.4 Allocation policies, logistics, and resource demands of living-related donor and split liver grafts: — the American experience.- 2.1 Anatomy of the liver.- 2.2 Consequences of anatomy for the split liver surgeon.- 2.3 Which liver is splitable?.- 3.1 The Paris technique.- 3.2 Technique for ex situ cadaveric liver graft division.- 3.3 Technique of left-lateral in situ splitting.- 3.4 In situ splitting “Full right — Full left” for two adult recipients.- 4.1 How much liver does the patient need?.- 4.2 Transplantation of the right liver graft - technical aspects.- 4.3 Technique of implantation of the left graft.- 5.1 Results of ex situ split liver transplantation.- 5.2 Results of in situ splitting.- 5.3 The paradigm of split liver transplantation: a word of caution.- 5.4 Split liver transplant for two adults: initial experience at Paul Brousse Hospital.- 5.5 Split liver transplantation outlook to the future.

Editorial Reviews

Reviewer: William C. Chapman, MD (Washington University School of Medicine)
Description: This book represents work presented by 35 contributors at a symposium on split liver transplantation in Hamburg, Germany. As a result, there is some repetition and overlap of material presented by various coauthors. However, this is a technically challenging field and the contrasting approach presented by experts from different institutions is helpful to the physician interested in this field.
Purpose: Although split liver transplantation has been reported in single or small case series for a number of years, the results in adults have been inferior to whole organ liver transplantation and this has led many centers to resist use of this method of transplantation. The aim of this book is to provide transplant surgeons who wish to start or expand split liver transplantation with the current data available for the field. Although no definitive text exists for this developing area, this book does provide results from the most experienced centers in the field. In this way, transplant centers can learn from each others' experiences, potentially improving results and expanding the use of liver splitting to expand organ utilization.
Audience: This book may be of interest to anyone involved in the field of liver transplantation including students, residents, and nurses. However, because of the advanced technical nature of the material, it is primarily targeted to the transplant surgeon considering split liver transplantation and to a lesser degree, transplant hepatologists participating in patient selection for such procedures. The authors represent centers with significant experience in this still young field.
Features: This book reviews the entire field of split liver transplantation, including historical developments, the current status of the field, and areas of future research and expansion. The specific technical details important for the success of split liver transplantation are reviewed in detail, including patient selection, anatomical considerations, and logistical issues important in carrying out such transplants on a broader scale. A minor limitation of the book is the absence of a subject index.
Assessment: This book provides an important resource for the surgeon interested in, or currently performing, split liver transplantation. Although the process of combining multiple presentations by different authors from diverse centers results in irregular writing styles and overlap of details in many of the chapters, this is a minor drawback of the book. Overall, a wealth of material is presented for this young and developing field.

Doody's Review Service

Reviewer: William C. Chapman, MD (Washington University School of Medicine)
Description: This book represents work presented by 35 contributors at a symposium on split liver transplantation in Hamburg, Germany. As a result, there is some repetition and overlap of material presented by various coauthors. However, this is a technically challenging field and the contrasting approach presented by experts from different institutions is helpful to the physician interested in this field.
Purpose: "Although split liver transplantation has been reported in single or small case series for a number of years, the results in adults have been inferior to whole organ liver transplantation and this has led many centers to resist use of this method of transplantation. The aim of this book is to provide transplant surgeons who wish to start or expand split liver transplantation with the current data available for the field. Although no definitive text exists for this developing area, this book does provide results from the most experienced centers in the field. In this way, transplant centers can learn from each others' experiences, potentially improving results and expanding the use of liver splitting to expand organ utilization. "
Audience: This book may be of interest to anyone involved in the field of liver transplantation including students, residents, and nurses. However, because of the advanced technical nature of the material, it is primarily targeted to the transplant surgeon considering split liver transplantation and to a lesser degree, transplant hepatologists participating in patient selection for such procedures. The authors represent centers with significant experience in this still young field.
Features: This book reviews the entire field of split liver transplantation, including historical developments, the current status of the field, and areas of future research and expansion. The specific technical details important for the success of split liver transplantation are reviewed in detail, including patient selection, anatomical considerations, and logistical issues important in carrying out such transplants on a broader scale. A minor limitation of the book is the absence of a subject index.
Assessment: This book provides an important resource for the surgeon interested in, or currently performing, split liver transplantation. Although the process of combining multiple presentations by different authors from diverse centers results in irregular writing styles and overlap of details in many of the chapters, this is a minor drawback of the book. Overall, a wealth of material is presented for this young and developing field.