Meeting Information
Meeting Overview
The 5th Congress of the ILTS in Pittsburgh was attended by approximately 500 registrants. The meeting was preceded by a full day "Living Donor and Split Liver Transplantation Symposium" supported by Fujisawa. This meeting was opened by Ronald W. Busuttil, MD, Ph.D. with a "Historical Perspective and Rationale for Living Donor and Split Liver Transplantation." He stated that expanding the donor pool was "the wellspring of the entire symposium." Other information he presented included that the world experience is now > 1000 living related liver transplants & that right lobe grafting was the most popular technique. He mentioned that biliary tract problems were the "Achilles heel" of this operation. He also believes that split liver transplantation will increase the number of donor organs, and possibly make living related and reduced lobe transplant obsolete and perhaps " provide enough liver grafts for the entire pediatric recipient pool." He also indicated that "over the past 8 years, close to 500 split grafts using the ex- vivo technique have been transplanted with graft and patient survivals which are less than whole organ grafting. However, with increasing experience, results have improved so that split liver grafts now offer the elective adult patient results comparable to whole grafts."
Much discussion and debate was given to the virtues of ex-vivo versus in-vivo splitting of the liver. It appears that in experienced groups, both techniques can be utilized with little effect from increased cold ischemia times although this issue is far from resolution.
Mark Siegler, MD, Director, McLean Center for Clinical Medical Ethics, University of Chicago, spoke on "Ethical Considerations in Living Donor and Split Liver Transplantation." His input was a good beginning for this critical issue now facing the liver transplantation community. Dr. Siegler said that "donor risk was somewhat unsettled." He advanced the view that innovative procedures should be introduced into clinical practice by a process including peer review, public and professional responses, and submission of pilot clinical trials for IRB approval. Trials then used to gather clinical, psychosocial, and ethical data that then must be published. We believe this is a most critical subject that requires immediate attention and would suggest rapidly convening a full-day symposium dedicated to this issue.
Another area of controversy, "Allocation Policies and Resource Demands of Living Donor and Split Liver Transplantation" was presented by Dr. Jorge Reyes and appears elsewhere in this newsletter. It should be noted that there are now over 20 centers doing split liver procedures.
Sir Roy Calne, the first speaker at the opening plenary session remarked that Dr. Starzl was responsible for the first human liver transplant in 1963 & that approximately 32, 800 livers have now been transplanted in Europe. He also provided some exciting preliminary human data on a new anti-CD 52 antibody.
The focal point of this Congress was reached on Friday evening at the Gala Reception and Banquet honoring Dr. Thomas Starzl. The dinner courses were interspersed with talks and video vignettes featuring comments from colleagues, former fellows, family, patients and friends. All the speakers (including Dr. Francis Moore who pointed out that this year is the 50th anniversary of the first transplant) were eloquent during this emotional tribute.


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