NewYork-Presbyterian/Columbia University Irving Medical Center Leads Efforts to Increase Utilization of Split Liver Transplant in U.S.
The Liver Transplant Program at NewYork-Presbyterian/Columbia University Irving Medical Center is leading efforts to increase the utilization of split liver transplantation in the US, including training new surgeons in the procedure, conducting research showing that outcomes from SLT are not inferior, and helping to change policy around organ allocation and scoring.
Split liver transplant (SLT) is grossly underutilized in the US—only 4.5% of deceased donor liver transplantations involve SLTs, according to current statistics. The first SLT was performed by the Liver Transplant Program at NewYork-Presbyterian/Columbia University Irving Medical Center in 1998. Since then, our program has continued to lead efforts to increase the utilization of SLT, performing 128 SLTs to date. Our use of SLT has increased since 2008, with our team transplanting 5 to 13 cases each year using SLT livers. In 2020, NewYork-Presbyterian/Columbia performed 97 liver transplants—85 from deceased donors (of which, 9 were SLTs) and 12 from living donors.
Refining Surgical Skill
Because SLT is a technically demanding procedure and requires advanced surgical skill, only a handful of centers across the country are experienced performing the procedure. Practicing surgeons from around the country often visit the Liver Transplant Program at NewYork-Presbyterian/Columbia to observe and learn some of the more technical aspects of SLT.
Adjustments to the U.S. allocation and scoring system may be needed for more centers to fully utilize SLT. Although the United Network for Organ Sharing (UNOS) has created criteria for splitting organs, these guidelines have yet to be implemented into policy to expand the donor pool. Currently, Tomoaki Kato, MD, Surgical Director of Adult and Pediatric Liver and Intestinal Transplantation at NewYork-Presbyterian/Columbia, is working with the pediatric liver consortium group to publish a paper to confirm that SLT is not inferior to whole organ liver transplant, as was previously reported in an early experience.
Leaders in SLT
As one of a handful of centers in the country to utilize SLT in children and adults, NewYork-Presbyterian/Columbia is helping to expand the donor pool. Because our center utilizes SLT in addition to other tools to expand the donor pool, liver transplant candidates who come to our center have a better chance of receiving a transplant and experience a shorter time on average on the waitlist.
Learn more about liver transplantation performed at NewYork-Presbyterian/Columbia University Irving Medical Center.
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