Split-Liver Transplant for Two Adults in a Spanish Hospital

Abstract

Split-liver transplant is a procedure in which the donor liver is divided into two grafts. It was developed to increase the number of grafts for the pediatric population, while its use was not justified for adults given the disappointing initial results [1]. Currently, its use is justified because of the good results obtained when there is adequate selection of the donor, the recipients, and the technical preparation; the shortage of donors; and the mortality of patients on the waiting list [2]. We present a split-liver transplant using two adult recipients and their results after 1 year.The donor was a male (30 years; 85 kg; body mass index, 25 kg/m) with brain death secondary to a craneoencephalic traumatism, without pathological antecedents or the ingestion of alcohol. His stay in the ICU was for 3 days. He presented hemodynamic stability, with normal liver function test results (GPT, 15 U/L; GOT, 12 U/L), a plasmatic sodium concentration of 152 mEq/L, negative viral test results, and normal liver echography. A split-liver transplant was performed in situ, in which the main portal vein and the common bile duct were left with the right graft, and the celiac trunk, the middle hepatic vein, and segment IV with the left graft. A partition of the vena cava was carried out in the lengthwise direction.A. Ríos ( ) Avenida de la Libertad 208,