Adult split liver transplantation to treat liver cancer: a single-center retrospective study

doi:10.5847/wjem.j.1920-8642.2024.098

Abstract

Abstract:

BACKGROUND The increasing morbidity of liver cancer has led to a growing demand for transplantation. Split liver transplantation (SLT) is a promising way to ameliorate organ shortages. However, the safety and efficacy of SLT are still controversial. The aim of this study was to assess the clinical outcome of SLT in liver cancer patients at our center.

METHODS: A total of 74 patients who received liver transplantation at a tertiary hospital from March 2019 to July 2023 were retrospectively studied, of whom 37 recipients underwent SLT and 37 recipients underwent whole-graft liver transplantation (WGLT). Clinical data were analyzed and compared between patients who underwent SLT and WGLT.

RESULTS: SLT and WGLT were successfully performed, with no intraoperative transplant-related mortality. Postoperatively, no significant differences in total bilirubin (TB, P=0.266), alanine transaminase (ALT, P=0.403) and aspartate transaminase (AST, P=0.160) levels within 30 d were detected between the two groups. The transplant-related mortality rates were 8.1% in the SLT group and 5.4% in the WGLT group within 30 d of surgery (P=1.000), and 10.8% and 8.1%, respectively, at 90 d after surgery (P=1.000). There were no significant differences in overall survival (OS) and progress-free survival (PFS) between the SLT and WGLT groups (P=0.910, P=0.190).

CONCLUSION: Our results show that SLT does not imply additional risks in treating liver cancer compared with WGLT.

Key words: Adult, Split liver transplantation, Liver cancer, Prognosis, Retrospective

Qiang Sun, Haoze Cao, Xuesong Bai, Xin Han, Wanlu You, Zhongquan Sun, Yixin Zhang, Xiaochang Wu, Feng Fang, Fan Wu, Lianyue Yang, Sheng Yan, Yuan Ding, Weilin Wang. Adult split liver transplantation to treat liver cancer: a single-center retrospective study[J]. World Journal of Emergency Medicine, 2025, 16(1): 57-62.

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Variables	SLT (n=37)	WGLT (n=37)	P-value
Age, years, mean±SD	52.4±10.1	54.5±8.6	0.327
BMI, kg/m², mean±SD	22.76±3.02	23.51±2.74	0.265
Male, n (%)	32 (86.5)	33 (89.2)	1.000
Total protein, g/L, mean±SD	70.24±9.59	68.70±8.57	0.470
Albumin, g/L, mean±SD	36.53±5.73	35.15±5.53	0.294
Globulin, g/L, mean±SD	33.71±8.00	33.56±6.85	0.931
Prothrombin time, s, mean±SD	22.15±7.17	19.68±6.21	0.118
Total bilirubin, μmoI/L, mean±SD	137.76±118.70	105.91±121.27	0.257
HBsAg positive rate, n (%)	34 (91.9)	34 (91.9)	1.000
White blood cell, ×10⁹/L, mean±SD	4.46±2.49	4.19±2.99	0.683
Hemoglobin, g/L, mean±SD	114.84±30.48	115.54±26.10	0.915
Platelet, ×10⁹/L, mean±SD	87.78±76.58	81.24±68.35	0.699

Variables	SLT (n=37)	WGLT (n=37)	P-value
Intraoperative blood loss, mL, mean±SD	833.78±952.78	682.78±442.00	0.390
30-day mortality rate, n (%)	3 (8.1)	2 (5.4)	1.000
90-day mortality rate, n (%)	4 (10.8)	3 (8.1)	1.000
Postoperative hospital stays, d, mean±SD	25.03±22.69	19.62±6.73	0.172

Cause of death	SLT	WGLT
Infection	2	1
Graft dysfunction	1	2
Vascular complications	1	-
Total	4	3

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