REDUCED-SIZE HEPATIC ALLOGRAFTS

Reduced-size hepatic transplantation (RSHT) was developed to alleviate the mortality resulting from the scarcity of suitable cadaveric graft s. RSHT consists of various techniques that reduce a full liver to a s maller size. These techniques include reduced-size cadaveric liver tra nsplantation (RLT), split liver transplantation (SLT), and living-rela ted Liver transplantation (LRLT). RLT utilizes part of a liver, while the rest is discarded; in SLT, the whole liver is used for two recipie nts after bipartition; and in LRLT, a portion of the liver retrieved f rom 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 yi elds results comparable to full-liver allografting and drastically red uces the mortality of patients waiting for transplantation. The proced ures involved are technically demanding and should be restricted to ex perienced liver centers.