Studies of Pediatric Liver Transplantation (SPLIT)

Studies of Pediatric Liver Transplantation (SPLIT) is a multicenter research study involving more than 30 liver transplant centers in North America. SPLIT was started in 1995 by a group of doctors committed to the success of pediatric liver transplant. This organization now has data on more than 2,000 liver transplants in children, with the goal of collecting and analyzing this information to improve the care of pediatric liver patients.

Seattle Children's Hospital is an active member in this partnership between transplant centers in the United States and Canada. The information collected by SPLIT provides vital data to the pediatric transplant community, including a better understanding of the issues patients and their families face.

The mission of the study is to follow trends, indications and outcomes for:

  • Growth parameters
  • Anti-rejection therapy
  • Patient and graft survival
  • Rejection incidence
  • Transplant and specific techniques

All liver transplant patients are welcome to participate in SPLIT studies being conducted at Seattle Children's.

Split- and Reduced-Liver Transplants

Because a whole liver that is compatible with a child is so hard to find, specialists who treat children who have liver disease have spent years researching surgical treatment options. This has resulted in innovative procedures that increase the opportunities for transplant while working with the limited number of deceased-donor livers available.

At Seattle Children's Transplant Center, up to 40% of liver transplants are split- or reduced-liver transplants.

In a split-liver transplant, the donor liver is divided into two parts and transplanted into two recipients, most often an adult and a child. The process maximizes the usefulness of a single donor liver.

In a reduced-liver transplant, surgeons take a portion of a deceased donor's liver and place it in a child. Reduced-liver transplants make sure the donor liver properly fits a pediatric patient.

Learn more about liver organ donation.

ABO Incompatibility

Most liver transplant cases require a good blood-type match between a donor and a recipient for best outcome. A, B and O are the three major blood types. "ABO incompatibility" describes an immune reaction that occurs in the body if two blood samples of different, incompatible blood types are mixed together. People of a given blood type will form antibodies against other blood types.

For example, children with blood type O need to receive a liver from a donor with the same blood type, O. Children with blood type A can receive a liver from a donor with blood type A or O, but not B.

Seattle Children's will perform an ABO-incompatible transplant to save a critically ill child's life when a compatible liver cannot be found in time to save the child. This procedure is reserved for patients in the intensive care unit, often in a coma from liver failure.

Diseases of the Liver in Children

Drs. Karen Murray and Simon Horslen have co-edited Diseases of the Liver in Children, providing a comprehensive review of pediatric liver disease with practical approaches for the primary care provider or general gastroenterologist.