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  • Title: Whole liver versus split liver versus living donor in the adult recipient: an analysis of outcomes by graft type.
    Author: Humar A, Beissel J, Crotteau S, Kandaswamy R, Lake J, Payne W.
    Journal: Transplantation; 2008 May 27; 85(10):1420-4. PubMed ID: 18497681.
    Abstract:
    BACKGROUND: We studied patient and graft survival rates in adult liver transplant recipients, analyzing outcomes based on donor source (deceased donor [DD] vs. living donor [LD]) and graft type (whole liver vs. partial liver). METHODS: A retrospective database analysis of all adult liver transpants performed at our center over a 7-year period of time. RESULTS: Between 1999 and 2005, 384 liver transplants were performed in adult recipients, either as a whole liver from a deceased donor (DD-WL, n=284), split liver from a DD (DD-SL, n=31), or a partial transplant from a living donor (LD, n=69). DD-SL transplants were performed with a full right or left lobe graft, while LD transplants used the right lobe. Demographic differences in the three groups were most noticeable for lower model for end-stage liver disease scores in LD recipients (P<0.001) and younger donor age in DD-SL recipients (P<0.001). Superior graft survival results were seen in LD recipients versus either DD-WL recipients or DD-SL recipients (P=0.02 and P=0.05, respectively). Multivariate analysis showed hepatitis C (HR=1.53, P=0.05) and hepatocellular carcinoma (HR=1.74, P=0.03) to be significant risk factors for patient survival. Hepatitis C (HR=1.61, P=0.03) and donor age more than 50 (HR=1.64, P=0.04) were significant risk factors for graft survival. However, neither graft type nor donor source were significant independent risk factors for patient or graft survival. CONCLUSIONS: Our data suggests that the status of the recipient is probably a more important determinant of outcome than graft type or donor source.
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