Expert consensus on dual-graft liver transplantation in West China Hospital_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

Lü Tao ^1,2 ^呂 , XU Gang ^1,2 , XU Xi ^1,2 , YANG Jian ^1,2 , SONG Jiulin ^1,2 , WANG Shouping ^1,2 , Yiliyaer Aierken ^1,2 , KONG Lingxiang ^1,2 , YUAN Jingsheng ^1,2 , WEN Tianfu ^2,3 , YAN Lünan ^1,2 ,  WU Hong ^1,2 ,  YANG Jiayin ^1,2

1. Liver Transplant Center, Transplant Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. Division of Liver Sugery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

WU Hong, Email: wuhong7801@163.com; YANG Jiayin, Email: doctoryjy@scu.edu.cn

Keywords：

dual-graft liver transplantation; living organ donation; organ donation after citizen death

DOI：

10.7507/1007-9424.202402061

Video：

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Living donor liver transplantation is one of the main solutions to the organ supply-demand discrepancy at present. However, there was a risk of the recipient developing small-for-size syndrome due to insufficient graft volume, while an excessively large graft volume for donation might lead to postoperative liver failure for the donor. In this context, the dual-graft liver transplantation had emerged, which could minimize the volume of liver resection from the each donor to ensure the donor’s safety and provide the adequate volume of liver for the recipient. Yet, this procedure is less commonly performed in our country. In order to promote the steady implementation of dual-graft liver transplantation in China and serve as an important supplement to the donor pool, the West China Hospital of Sichuan University organized relevant experts and draw on the mature experiences of advanced countries in the field of transplantation jointly formulated the “Expert consensus on dual-graft liver transplantation”. The consensus had been developed around aspects such as donor evaluation and selection, surgical methods, and postoperative complications.

Citation： Lü Tao, XU Gang, XU Xi, YANG Jian, SONG Jiulin, WANG Shouping, Yiliyaer Aierken, KONG Lingxiang, YUAN Jingsheng, WEN Tianfu, YAN Lünan, WU Hong, YANG Jiayin. Expert consensus on dual-graft liver transplantation in West China Hospital. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(4): 385-388. doi: 10.7507/1007-9424.202402061 Copy

1.	Lee S, Hwang S, Park K, et al. An adult-to-adult living donor liver transplant using dual left lobe grafts. Surgery, 2001, 129(5): 647-650.
2.	Khan A, Arkam F, Dar FS, et al. Dual graft living donor liver transplantation for high acuity patients: a single-center experience. J Clin Exp Hepatol, 2023, 13(3): 447-453.
3.	Kwon JH, Song GW, Hwang S, et al. Dual-graft adult living donor liver transplantation with ABO-incompatible graft: short-term and long-term outcomes. Am J Transplant, 2018, 18(2): 424-433.
4.	Song GW, Lee SG, Moon DB, et al. Dual-graft adult living donor liver transplantation: an innovative surgical procedure for live liver donor pool expansion. Ann Surg, 2017, 266(1): 10-18.
5.	嚴律南, 曾勇, 王文濤, 等. 成人間雙供體活體肝臟移植成功2例報告. 中國普外基礎與臨床雜志, 2005, 12(4): 399-402.
6.	Brown RS. Live donors in liver transplantation. Gastroenterology, 2008, 134(6): 1802-1813.
7.	Chen YS, Cheng YF, De Villa VH, et al. Evaluation of living liver donors. Transplantation, 2003, 75(3 Suppl): S16-S19. doi: 10.1097/01.TP.0000046535.49186.EB.
8.	Fan ST, Lo CM, Liu CL, et al. Safety of donors in live donor liver transplantation using right lobe grafts. Arch Surg, 2000, 135(3): 336-340.
9.	Lee SG, Moon DB, Hwang S, et al. Liver transplantation in Korea: past, present, and future. Transplant Proc, 2015, 47(3): 705-708.
10.	Park GC, Song GW, Moon DB, et al. A review of current status of living donor liver transplantation. Hepatobiliary Surg Nutr, 2016, 5(2): 107-117.
11.	Trotter JF, Wachs M, Everson GT, et al. Adult-to-adult transplantation of the right hepatic lobe from a living donor. N Engl J Med, 2002, 346(14): 1074-1082.
12.	Barr ML, Belghiti J, Villamil FG, et al. A report of the Vancouver Forum on the care of the live organ donor: lung, liver, pancreas, and intestine data and medical guidelines. Transplantation, 2006, 81(10): 1373-1385.
13.	中華醫學會外科學分會外科手術學學組, 中華醫學會外科學分會移植學組. 劈離式肝移植專家共識. 中華肝臟外科手術學電子雜志, 2020, 9(5): 429-434.
14.	Vinayak N, Ravi M, Ankush G, et al. Dual graft living donor liver transplantation—a case report. BMC Surg, 2019, 19(1): 149. doi: 10.1186/s12893-019-0606-5.
15.	Zidan A, Sturdevant M, Alkhail FA, et al. The first two cases of living donor liver transplantation using dual grafts in Saudi Arabia. Ann Saudi Med, 2019, 39(2): 118-123.
16.	Xiao Y, Huang X, Shi Y, et al. Emergent hybrid-dual-graft liver transplantation: a life-saving strategy for a patient with inadequate living donor graft during the COVID-19 pandemic. Hepatobiliary Surg Nutr, 2022, 11(5): 785-788.
17.	Kim JD, Choi DL, Han YS. Salvage dual graft living donor liver transplantation after major hepatectomy. Ann Surg Treat Res, 2014, 87(2): 108-111.
18.	Lee SG, Hwang S, Park KM, et al. Seventeen adult-to-adult living donor liver transplantations using dual grafts. Transplant Proc, 2001, 33(7-8): 3461-3463.
19.	Chen Z, Yan L, Li B, et al. Prevent small-for-size syndrome using dual grafts in living donor liver transplantation. J Surg Res, 2009, 155(2): 261-267.
20.	Chen Z, Zeng Y, Wen TF, et al. Dual grafts live donor liver transplantation for acute-on-chronic hepatitis B liver failure. Transplant Proc, 2010, 42(10): 4552-4554.
21.	Xu Y, Chen H, Yeh H, et al. Living donor liver transplantation using dual grafts: Experience and lessons learned from cases worldwide. Liver Transpl, 2015, 21(11): 1438-1448.
22.	夏強. 雙供一受肝移植的選擇與實施. 肝膽外科雜志, 2015, 23(4): 241-242.
23.	王文濤, 嚴律南, 李波, 等. 二例成人間雙活體供肝移植的手術重建技巧. 中華器官移植雜志, 2006, 27(5): 277-279.
24.	張博瀚, 宋九林, 蔣利, 等. 成人活體供者肝右葉聯合腦死亡捐獻者肝左外葉的雙供肝活體肝移植治療肝細胞癌的應用價值. 中華消化外科雜志, 2020, 19(2): 196-203.
25.	Wan Z, Wang X, Zhang X, et al. Atrophy of the left graft secondary to arterial inflow failure in dual liver transplantation. Exp Clin Transplant, 2021, 19(6): 617-619.

1. Lee S, Hwang S, Park K, et al. An adult-to-adult living donor liver transplant using dual left lobe grafts. Surgery, 2001, 129(5): 647-650.
2. Khan A, Arkam F, Dar FS, et al. Dual graft living donor liver transplantation for high acuity patients: a single-center experience. J Clin Exp Hepatol, 2023, 13(3): 447-453.
3. Kwon JH, Song GW, Hwang S, et al. Dual-graft adult living donor liver transplantation with ABO-incompatible graft: short-term and long-term outcomes. Am J Transplant, 2018, 18(2): 424-433.
4. Song GW, Lee SG, Moon DB, et al. Dual-graft adult living donor liver transplantation: an innovative surgical procedure for live liver donor pool expansion. Ann Surg, 2017, 266(1): 10-18.
5. 嚴律南, 曾勇, 王文濤, 等. 成人間雙供體活體肝臟移植成功2例報告. 中國普外基礎與臨床雜志, 2005, 12(4): 399-402.
6. Brown RS. Live donors in liver transplantation. Gastroenterology, 2008, 134(6): 1802-1813.
7. Chen YS, Cheng YF, De Villa VH, et al. Evaluation of living liver donors. Transplantation, 2003, 75(3 Suppl): S16-S19. doi: 10.1097/01.TP.0000046535.49186.EB.
8. Fan ST, Lo CM, Liu CL, et al. Safety of donors in live donor liver transplantation using right lobe grafts. Arch Surg, 2000, 135(3): 336-340.
9. Lee SG, Moon DB, Hwang S, et al. Liver transplantation in Korea: past, present, and future. Transplant Proc, 2015, 47(3): 705-708.
10. Park GC, Song GW, Moon DB, et al. A review of current status of living donor liver transplantation. Hepatobiliary Surg Nutr, 2016, 5(2): 107-117.
11. Trotter JF, Wachs M, Everson GT, et al. Adult-to-adult transplantation of the right hepatic lobe from a living donor. N Engl J Med, 2002, 346(14): 1074-1082.
12. Barr ML, Belghiti J, Villamil FG, et al. A report of the Vancouver Forum on the care of the live organ donor: lung, liver, pancreas, and intestine data and medical guidelines. Transplantation, 2006, 81(10): 1373-1385.
13. 中華醫學會外科學分會外科手術學學組, 中華醫學會外科學分會移植學組. 劈離式肝移植專家共識. 中華肝臟外科手術學電子雜志, 2020, 9(5): 429-434.
14. Vinayak N, Ravi M, Ankush G, et al. Dual graft living donor liver transplantation—a case report. BMC Surg, 2019, 19(1): 149. doi: 10.1186/s12893-019-0606-5.
15. Zidan A, Sturdevant M, Alkhail FA, et al. The first two cases of living donor liver transplantation using dual grafts in Saudi Arabia. Ann Saudi Med, 2019, 39(2): 118-123.
16. Xiao Y, Huang X, Shi Y, et al. Emergent hybrid-dual-graft liver transplantation: a life-saving strategy for a patient with inadequate living donor graft during the COVID-19 pandemic. Hepatobiliary Surg Nutr, 2022, 11(5): 785-788.
17. Kim JD, Choi DL, Han YS. Salvage dual graft living donor liver transplantation after major hepatectomy. Ann Surg Treat Res, 2014, 87(2): 108-111.
18. Lee SG, Hwang S, Park KM, et al. Seventeen adult-to-adult living donor liver transplantations using dual grafts. Transplant Proc, 2001, 33(7-8): 3461-3463.
19. Chen Z, Yan L, Li B, et al. Prevent small-for-size syndrome using dual grafts in living donor liver transplantation. J Surg Res, 2009, 155(2): 261-267.
20. Chen Z, Zeng Y, Wen TF, et al. Dual grafts live donor liver transplantation for acute-on-chronic hepatitis B liver failure. Transplant Proc, 2010, 42(10): 4552-4554.
21. Xu Y, Chen H, Yeh H, et al. Living donor liver transplantation using dual grafts: Experience and lessons learned from cases worldwide. Liver Transpl, 2015, 21(11): 1438-1448.
22. 夏強. 雙供一受肝移植的選擇與實施. 肝膽外科雜志, 2015, 23(4): 241-242.
23. 王文濤, 嚴律南, 李波, 等. 二例成人間雙活體供肝移植的手術重建技巧. 中華器官移植雜志, 2006, 27(5): 277-279.
24. 張博瀚, 宋九林, 蔣利, 等. 成人活體供者肝右葉聯合腦死亡捐獻者肝左外葉的雙供肝活體肝移植治療肝細胞癌的應用價值. 中華消化外科雜志, 2020, 19(2): 196-203.
25. Wan Z, Wang X, Zhang X, et al. Atrophy of the left graft secondary to arterial inflow failure in dual liver transplantation. Exp Clin Transplant, 2021, 19(6): 617-619.

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Expert consensus on dual-graft liver transplantation in West China Hospital

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