Split liver transplantation: technique and results

The term split-liver transplantation is defined as the division of a deceased-donor liver into 2 different parts that are separately transplanted into 2 different recipients. Two entities may be identified: the first dividing the liver into the small left lateral segment to be transplanted into a small child and the right lobe to be transplanted into an adult recipient. This is a well-established and standard technique leading to excellent results in experienced centers. The second entity, more recently introduced and less standardized, divides the liver into 2 similarly sized parts, both suitable for transplantation into adults or adult-sized children. This article describes the most relevant aspects of the surgical technique and the results of both types of split liver transplantation based on the author's own experience and a review of the literature. Some aspects of the limitation to the diffusion of these procedures and on a possible future scenario are also discussed.