Evaluation de la faisabilité de la bipartition foie droit/foie gauche pour transplantation hépatique chez deux adultes: A partir de 100 greffons consécutifs

Aim - To evaluate the feasibility of splitting a liver graft for transplantation in two adult patients. Patients and methods - We retrospectively collected data on the harvesting of 100 consecutive liver grafts. Data were separated into 4 groups to establish feasibility criteria, according to the chronological steps of harvesting: 1) initial criteria about the donor (age, weight, biological tests), 2) criteria concerning the liver graft at the time of harvesting (macroscopic appearence, graft weight, hemodynamic state of donor), (3) anatomical criteria and (4) histological criteria. Results - If our criteria for the feasibility of splitting a liver graft for transplantation in two adults had been applied, 47 grafts would have been rejected based on initial criteria, 34 at the time of harvesting and 6 because of anatomical or histological evaluation. Finally, 13 liver grafts would have been accepted for splitting and then transplantation in two adults. Conclusions - Split-liver transplantation for two adult recipients could increase the graft pool by 13%. This procedure requires technical changes in organ harvestingt and coordination among centers.