Worth continuing doing ex situ liver graft splitting? A single-center analysis

Huda M. Noujaima, Bridget Gunson, David A. Mayer, Darius F. Mirza, John A C Buckels, Daniel Candinas, Paul McMaster, Jean De Ville de Goyet

Research output: Contribution to journalArticlepeer-review


Grafts for split liver transplantation can be prepared in situ during the retrieval operation, or ex situ on the back table. The in situ technique has theoretical advantages because it minimizes the cold ischemic time and allows excellent hemostasis at the cut surface. However, in situ liver division prolongs the retrieval procedure, may precipitate hemodynamic instability in the donor, and may cause logistical difficulties for some centers. This report is a single-center analysis comparing results of ex situ liver division (group I: 1992-97; and group II: 1998-2001) before and after a new protocol for liver graft division was introduced in our center. Eighty-nine split liver transplants (SLT) were reviewed retrospectively. Vascular complications were less common in group II (3.3% vs. 20%; p = 0.04), and 1-year graft survival increased from 59% to 78% (p = 0.03). Since 1998, 1-year graft survival of SLT has been similar to that of conventional liver graft transplantation in our center (78% and 74%, respectively). In conclusion, good results can be achieved from splitting livers ex situ and this procedure should be considered when the in situ technique is not feasible.

Original languageEnglish
Pages (from-to)318-323
Number of pages6
JournalAmerican Journal of Transplantation
Issue number3
Publication statusPublished - Mar 2003


  • Liver division
  • Liver transplantation
  • Outcome
  • Split liver graft
  • Surgical complications
  • Surgical techniques

ASJC Scopus subject areas

  • Immunology


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