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Use of Segmental Grafts in Adult and Pediatric Liver Transplantation: Improving Outcomes and Minimizing Vascular Complications.
*Manuel I Rodriguez-Davalos, *Antonios Arvelakis, *Veysel Umman, *Vijayakumar Tanjavur, *Sanjay Kulkarni, *Michael Schilsky, *Sukru Emre
Yale University, New Haven, CT

Describe the use of segmental allografts as an important strategy using innovative surgical techniques in liver transplantation to increase organ availability.
Retrospective study of liver transplants performed from August 2007 to February 2012.
Academic Tertiary Care Center
Patients and Interventions:
199 consecutive Liver Transplants patients were reviewed, 59(29%) patients received segmental grafts. 33 males, mean age of 22yo (4m-69y). Received either living donor liver transplant (LDLTx) or a segmental transplant from a deceased donor (Split or Reduced size). Main Outcome Measures:
Graft type, vascular complications, patient&graft survival.
Out of 59 segmental transplants, 38 underwent LDLTx. 11(29%) grafts were Right Lobes, 16(42%) Left lobes and 11(29%)Left Lateral segments (LLS).
21 patients were transplanted with deceased donor segmental grafts of these 10(48%) were Right Trisegmentectomies, 9(42%) LLS, 1(5%) R-Lobe and 1(5%) L-lobe.
There were no HAT (0%), no PVT(0%)
One (1.6%) patient on the group developed hepatic artery stenosis (HAS) and was treated with balloon angioplasty by interventional radiology.
Arterial anastomosis were done using interrupted 8-0 monofilament sutures. Most patients received prophylactic dose of low molecular weight heparin for a week and aspirin indefinitely.
In split liver transplantation our preferred technique is in-situ splitting.
Graft and Patient survival was 98% and 100% respectively.
Use of segmental allografts is essential in order to offer timely transplantation and decreasing waiting list mortality. LDLTx and Segmental grafts from deceased donors are complementary. The outcomes presented are a combination of technical expertise, routine use of anticoagulation and strict patient and donor selection.

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Abstract Submission Deadline:
May 5, 2014

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August 13, 2014

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August 11, 2014
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