Transplantation 2000 Mar 15;69(5):1005-7

In situ split liver transplantation for two adult recipients

Sommacale D, Farges O, Ettorre GM, Lebigot P, Sauvanet A, Marty J, Durand F,
Belghiti J
Department of Digestive Surgery, Hopital Beaujon, University Paris VII, Clichy,
France

Abstract

BACKGROUND: Modifications of the in situ split liver technique are needed for
safe transplantation in two adult recipients with a single donor. METHODS: The
graft from a brain-dead donor, 187 cm tall and weighing 89 kg, was split in situ
with a transection performed along the main portal fissure retaining the middle
hepatic vein with the left graft. The right and left grafts, which weighed 985
and 760 g, respectively, were transplanted in two adult recipients weighing 70
and 56 kg, respectively. RESULTS: Both recipients had minor intraoperative blood
loss and were discharged from intensive care on day 3. Both grafts were rapidly
functional, and the two patients were in excellent condition with normal liver
function tests 9 months after surgery. CONCLUSION: In situ split liver
transplantation can be performed with the middle hepatic vein retained in the
left graft to obtain a sufficient volume of the two grafts suitable for two
adult recipients. This modification of the technique could expand the donor pool
for adult recipients