title: Split liver transplantation for two adult recipients.
abstract: We report a case of split liver transplantation for two adult recipients. The liver graft (1285 g) was split on the backtable into a right lobe graft (900 g, containing the inferior vena cava and middle hepatic vein) and a left lobe graft (385 g). The right lobe graft was implanted into a patient with hepatitis B cirrhosis uneventfully. The left lobe graft was implanted into a patient with familial amyloid polyneuropathy, but was met with massive bleeding from the transection surface and congestion of segment 4. The dusky appearance of segment 4 disappeared after hepatic artery anastomosis, but Doppler ultrasonography showed reverse blood flow in the segment 4 portal vein. Both patients survived the operation. The case illustrated that a left lobe graft without the middle hepatic vein could be problematic. To benefit two adults with chronic liver diseases, a better design of hepatic vein drainage of segment 4 in the left lobe graft and segment 5 and 8 in the right lobe graft is required.
authors.affiliation: Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China. hrmsfst@hkucc.hku.hk
authors.forename: Sheung-Tat
authors.initials: ST
authors.lastname: Fan
authors.forename: Chung-Mau
authors.initials: CM
authors.lastname: Lo
authors.forename: Chi-Leung
authors.initials: CL
authors.lastname: Liu
authors.forename: Boon-Hun
authors.initials: BH
authors.lastname: Yong
authors.forename: John Ka-Fat
authors.initials: JK
authors.lastname: Chan
mesh_terms: D000328:Adult; D028227:Amyloid Neuropathies, Familial / Q000150:complications* / Q000601:surgery*; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male