White Paper:
Split Versus Whole Liver
Transplantation
Ethics Committee
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What is this resource?
 Revised

white paper from the Ethics Committee
Committee had been tasked with updating a prior version written many years
earlier
 Provides
an ethical analysis and recommendations regarding
split-liver transplantation
 Target Audience:


Transplant hospitals or OPOs considering split liver transplantation
Candidates who may be evaluating split-liver transplantation versus whole-liver
transplantation
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Changes to the white paper
Committee completed a substantive revision of this white
paper addressing:







Ethics of optimal allocation
Current allocation of deceased donor allografts
Splitting a deceased donor allograft
Ethics of modifying allocation and practice to promote split liver transplantation
Informed consent
Center expertise
Additional challenges
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How will members access this resource?
 Members
will be able to access this resource through
the OPTN website
 Current
white papers are available under the
Resources tab, select Ethics
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Questions?
Peter Reese, M.D.
Committee Chair
[email protected]
Lee Bolton
Committee Liaison
[email protected]
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Supporting Evidence
January 1, 1995 – December 31, 2015
Total Deceased Donor Liver Transplants
Total Split Liver Transplants
Split Liver Allograft Transplants to
Pediatric Recipients
Whole Liver Transplants to Pediatric
Recipients
113,394
1546
1439
1.36%
93%
107
6.8%
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Supporting Evidence

New split liver criteria were adopted in November 2006.

From 19 months pre-adoption through 19 months post-adoption (April
2004–June 2009)

2,247 (10.3%) of 21,832 deceased donors met the criteria;

218 (1.1%) of 19,644 livers transplanted were split-liver transplants.
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Supporting Evidence

From June 1, 2001 through Dec. 31, 2015, 129,276 (85%) of
151,250 adult registrations for liver transplantation noted a
willingness to accept a split liver at listing

In 2015, 10,100 (90%) of 11,256 adult registrants for liver
transplantation noted a willingness to accept a split liver at listing
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