Technique of implantation of the left graft

Abstract

The split liver technique was originally devised to transplant children without discarding the excess liver parenchyma, which could be used to transplant an adult patient [1]. From this operation, which can be performed ex situ or in situ [2], derives a left graft constituted by segments II and III, or left lateral segment (LLS), and a right graft constituted by segments I and IV to VIII of Couinaud. Despite initial unsatisfactory results, the effort to render split liver transplantation an effective way to meet the needs of children for liver grafts without interfering with the adult waiting list continued, particularly, in Europe. The results of this effort are such that split liver transplantation has become a common practice in several centers around the world. In particular, the techniques of implantation of the LLS have reached a high degree of maturity which has its roots in nearly twenty years of experience with reduced-size liver transplantation.