Can Split Liver Transplantation be a Solution for Organ Shortage in Türkiye?

Objectives: First split liver transplantation (SLT) which was performed by Rudolph Pichlmayr in 1988, a great hope has arisen to reduce organ shortage. Split liver transplantation is a challenging procedure. Increased perioperative complications and allocation of the split organ affect the results. Selection of both a suitable donor and an appropriate recipient is essential to achieve successful results. We aim to review SLT outcomes performed at our center.
Methods: We have performed 3611 liver transplantations between February 2007 and May 2023. During this period 75 split livers were transplanted. We retrospectively analyzed the 75 split liver transplanted patients data and recorded the age, gender, the reason for liver transplantation, and the survivals.
Results: There were 75 patients. The median age was 12 (0-64). The main reason for liver transplantation was fulminant hepatic failure (47 %, n=35) The 5-year overall survival rate before 2016 was 33 % (n=69). After 2016, the 5-year overall survival rate was 67 % (n=6).
Conclusion: The splittable deceased organ number in our country is extremely low, so SLT will not be a solution for organ shortage in Türkiye. We believe that successful outcomes can only be achieved by performing an in situ split in the same center.