Split liver transplantation in adults

Core Tip

Core tip: Split liver transplantation (SLT) in adults is usually performed with the right trisegment graft or less frequently with the hemiliver graft. Both graft types require highly complex surgical techniques. Compared with the right trisegment graft, hemiliver SLT requires stricter donor and recipient selection to prevent graft dysfunction associated with size-mismatch. To achieve ideal graft-recipient paring, a clear understanding of surgical anatomy and recipient physiology is needed. With favorable circumstances, outcomes of adult SLT can be comparable to whole liver transplantation. The routine use of SLT, however, remains controversial due to various challenges, particularly under the current “sickest first” liver allocation policy.