DigestiveandLiverDisease42(2010)205–209ContentslistsavailableatScienceDirectDigestiveandLiverDiseasejournalhomepage:www.elsevier.com/locate/dldLiver,PancreasandBiliaryTractReductioninbileleaksfollowingadultsplitlivertransplantusingafibrin-collagensponge:ApilotstudyLucaToti∗,MagdyAttia,TommasoMariaManzia,IlariaLenci,BridgetGunson,JohnA.C.Buckels,DariusF.Mirza,A.DavidMayer,SimonR.Bramhall,StephenJ.WigmoreLiverUnit,QueenElizabethHospital,BirminghamB152TT,UKarticleinfoArticlehistory:Received8July2008Accepted17June2009Availableonline12November2009Keywords:BileleakFibrinspongeSplitlivertransplantationTachoSil®abstractIntroduction:Bileleaksareafrequentcomplicationofadultsplitlivertransplantation.Wecomparedsurgicalcomplicationsinpatientswhohadthecutsurfaceofthedonorlivertreatedwithapatchtothoseinwhomthecutsurfaceoftheliverwastreatedwithfibringlue.Materialandmethods:Twoconsecutivecohortsof16patientsundergoingadultrightlobesplitlivertransplantwerecompared.Inthefirstcohort,theliversurfacewastreatedwithfibringlueandinthesecondtheliversurfacewastreatedwithTachoSil®fibrinogen-thrombin-collagenpatches.Post-operativecomplicationswereanalyzed.Results:Bileleaksweresignificantlyfeweramongpatientsinwhomthecutsurfaceoftheliverwastreatedwithfibrin-collagenspongecomparedtothosewherefibringluewasusedonthecutsurface:1/16(6.25%)vs.7/16(43.75%),respectively;p=0.03.Thereweresomedifferencesinbiliaryanastomotictechniquesusedinthetwogroupsbut7/8leaks(87.5%)arosefromthecutsurface,andonlyonewasfromtheanastomosis.Conclusion:Usingafibrinogen-thrombin-collagenspongepatchmayreducebileleaksfromthecutsurfaceoftheliverduringadultrightlobesplitlivertransplants.©2009EditriceGastroenterologicaItalianaS.r.l.PublishedbyElsevierLtd.Allrightsreserved.1.IntroductionTheshortageofliversfortransplantation,particularlyinchil-dren,hasencouragedtheuseofsplitlivertransplantation(SLT).Asearlyas1969,Smith[1]proposedusingtheleftlateralliversegmentforpaediatricrecipients,withthefirstSLTsbeingperformedattheendofthe19...
