Reduced-size hepatic allografts

Abstract

Reduced-size hepatic transplantation (RSHT) was developed to alleviate the mortality resulting from the scarcity of suitable cadaveric grafts. RSHT consists of various techniques that reduce a full liver to a smaller size. These techniques include reduced-size cadaveric liver transplantation (RLT), split liver transplantation (SLT), and living-related liver transplantation (LRLT). RLT utilizes part of a liver, while the rest is discarded; in SLT, the whole liver is used for two recipients after bipartition; and in LRLT, a portion of the liver retrieved from a living donor is transplanted. Whereas RLT only redistributes the pool of organs to the advantage of pediatric recipients, both SLT and LRLT increase the availability of grafts for transplantation. RSHT yields results comparable to full-liver allografting and drastically reduces the mortality of patients waiting for transplantation. The procedures involved are technically demanding and should be restricted to experienced liver centers.