Liver Transpl 2000 Mar;6(2):239-40

Transplantation of three adult patients with one cadaveric graft: wait or innovate.

Azoulay D, Castaing D, Adam R, Mimoz O, Bismuth H

Centre Hepatobiliaire, Hopital Paul Brousse, Universite de Paris Sud and
Assistance Publique-Hopitaux de Paris, Villejuif, France.

Abstract
Graft shortage continues to prolong waiting times for adults requiring liver
transplantation. Living related donor transplantation is possible for only a
small minority of adults. The techniques for in situ splitting of the liver used
for right and left hepatectomies in living donors were adapted to a combined
split-liver-domino procedure to obtain right and left hemiliver grafts from a
patient undergoing total hepatectomy with liver transplantation for a metabolic
disorder. The two grafts were adequate in size and function for transplantation
to two adults with low priority for regular cadaver grafts. More frequent use of
split-liver techniques in cadaver donors could considerably reduce the graft
shortage and waiting time for adult liver recipients.