In Situ Splitting of the Cadaver Liver for Two Adult Recipients by LDLT Technique

BackgroundTo expand the donor pool, split liver transplantation is conventionally performed for one adult and one pediatric recipient. Application of this technique for two adult recipients can produce remarkable impact on the waiting list. Proper donor and recipient selection is crucial for the favorable outcome following full-right and full-left liver split. Right lobe adult to adult living donor liver transplantation (LDLT) is essentially a full right and full left split. However, LDLT techniques have not been used for full right and left split.MethodsWe performed in situ splitting of the whole liver using LDLT techniques from a hemodynamically stable young deceased donor and transplanted into two adult recipients, both with model for end-stage liver disease score of 17. The transection was carried out through the midplane of liver, generating a right lobe and a left lobe graft.ResultsBoth the recipients had uneventful postoperative recovery. At ten months of follow up, both the recipients are doing well with good liver function.ConclusionBased on the concept of living related liver transplantation, our case explores the technical feasibility of full-right and full-left in situ liver split.