Transplantation of two Patients with one liver: Analysis of a preliminary experience with 'Split-liver' grafting

J. C. Emond*, P. F. Whitington, J. R. Thistlethwaite, D. Cherqui, E. A. Alonso, I. S. Woodle, P. Vogelbach, S. M. Busse-Henry, A. R. Zucker, C. E. Broelsch

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

275 Scopus citations


Surgical reduction of donor livers to treat small children has been performed successfully in several centers. While this procedure improves the allocation of livers, it does not increase the organ supply. We have extended reduced-size orthotopic liver transplantation (OLT) to treat 18 patients with 9 livers, accounting for 26% of our transplants during a 10-month period and have evaluated the results. In 18 split liver OLTs, patient survival was 67% and graft survival was 50%. In comparison, for 34 patients treated with full-size OLT during the same period, patient survival was 84% (p = 0.298) and graft survival was 76% (p = 0.126). Biliary complications were significantly more frequent in split grafts, occurring in 27%, as compared to 4% in full-sized grafts (p = 0.017). Primary nonfunction (4% versus 5.5%) and arterial thrombosis (6% versus 9%) occurred with similar frequency in split and full-size OLT (p = not significant). These results demonstrated that split-liver OLT is feasible and could have a substantial impact in transplant practice. We believe that biliary complications can be prevented by technical improvements and that split-liver OLT will improve transplant therapy by making more livers available.

Original languageEnglish (US)
Pages (from-to)14-22
Number of pages9
JournalAnnals of surgery
Issue number1
StatePublished - Jul 1990

ASJC Scopus subject areas

  • Surgery


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