To expand the pool of livers available for transplantation, the transplant community should stress split liver transplants over living-related transplants, a number of surgeons suggested at the First International Symposium Dedicated to Expanding the Donor Pool, held in Pittsburgh in late August.
The meeting focused solely on issues related to split liver and living-related liver transplantations. Many of the attendees agreed that living-related transplants should be performed at only the most experienced transplant centers and that, even then, such operations could be risky for the donor.
"A better and safer way to expand the donor pool would be to encourage more transplants that use surgically divided livers from cadaveric donors, thus providing benefit to two patients from one organ donor. If put into more widespread practice, split liver transplants could eliminate deaths of children on the national waiting list and also offer adults an alternative source of organs without the risks associated with living-related transplants," said a statement by the meeting's sponsor, the University of Pittsburgh Medical Center.
According to UPMC, only 18 of the 125 liver transplant programs in the United States perform split liver transplants, and more widespread use of the procedure could lead to an estimated 500 to 600 more liver transplants in the United States every year.
"Full development of split liver transplantation may make living-related donation and reduced grafts obsolete except in emergent or special circumstances. In addition, the practice could provide enough liver grafts for the entire pediatric population," said meeting cochairman Ronald W. Busuttil, MD, PhD.
In a related story that affirmed the increasing popularity of living-donor donation, the United Network for Organ Sharing posted an account of what it called "the first 'stranger to stranger' living donor liver transplant" (www.unos.org/Newsroom/archive_story_19990820_schuler.htm). UNOS reported on August 20 that the transplant took place in April at Virginia Commonwealth University's Medical College of Virginia Hospitals. A 47-year-old man from Linville, Virginia, offered to donate part of his liver to a woman he had never met after hearing on a television newscast that the woman needed a new liver.
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