Opinion of Hepatic Transplant Waiting List Patients Regarding Split Liver Transplantation

Abstract Background Split liver transplantation (SLT) increases organ supply for hepatic transplantation. Long-term patient survival and complication rates seem to be equivalent between orthotopic liver transplantation (OLT) and SLT. There are controversies among transplant physicians due to an ethi...

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Published in:Transplantation proceedings 2008-04, Vol.40 (3), p.780-781
Main Authors: Petribu de Faria, E, Llanos, J.C, Neto, A.B, Silva, A.P.C, Winckler, C.C, Mutti, A, Saad-Hossne, R, Silva, G.F, Gomes, M.R.B, Callile de Paula, R.C, Biagioni, D.S, Almeida, R.A.M.B, Rosa, R.A.G, Guadagnucci, J.C
Format: Article
Language:English
Subjects:
Adult
Attitude to Health
Biological and medical sciences
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Humans
Liver Transplantation - methods
Liver Transplantation - psychology
Liver Transplantation - statistics & numerical data
Liver, biliary tract, pancreas, portal circulation, spleen
Medical sciences
Resource Allocation - methods
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Surveys and Questionnaires
Tissue and Organ Procurement - methods
Tissue Donors - supply & distribution
Tissue, organ and graft immunology
Waiting Lists
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Summary:Abstract Background Split liver transplantation (SLT) increases organ supply for hepatic transplantation. Long-term patient survival and complication rates seem to be equivalent between orthotopic liver transplantation (OLT) and SLT. There are controversies among transplant physicians due to an ethical dilemma between benefiting individual needs or those of society. Barshes and Goss (Am J Transplant 5:2047, 2005) demonstrated that the majority of adult liver transplant candidates are favorable to SLT. The aim of our study was to evaluate the opinions of patients at a Brazilian university hospital regarding SLT. Materials and Methods A questionnaire with 14 questions was applied to 50 patients included in a hepatic transplant waiting list regarding SLT. Results The overall attitudes of 66% of the participants were classified as utilitarian, 31% were classified as self-preserving, and 3% were undecided. Ninety-one percent of patients would be willing to share even if their expected survival after SLT was shorter than that with OLT. For 77% of patients, children must have priority over adults. However, 83% were unaware of the donors for pediatric transplantations. Conclusions SLT is a consistent solution for organ demand despite controversies among transplant physicians. The present study demonstrated that most patients were favorable to SLT. In conclusion, attitudes toward graft sharing are not barriers to SLT.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2008.02.060