title: Where are we today in split liver transplantation?
abstract: OBJECTIVE
  Results of surgical innovations using partial liver grafts from deceased donors have improved the availability of transplantable organs. However, current data on outcomes after split liver transplantation (SLT) are conflicting. This article reviews the current state of SLT, focusing on long-term outcomes and predictors for patient and graft survival after SLT.
  
  
  RESULTS
  The conventional SLT has been proven to be a durable life-saving procedure. Early results for full left-right SLT for two adults are promising but this technique had not showed efficacy for wide application. Predictors of diminished patient survival after SLT included the use of split grafts in critically ill recipients (model for end-stage liver disease score >30), retransplant patients, cold ischemia time more than 10 h, and the performance of SLT in low-volume liver transplant centers.
  
  
  CONCLUSIONS
  Conventional SLT performed in specialized centers resulted in long-term survival outcomes comparable with whole-organ liver transplantation. Full left-right SLT for two adults remains experimental. Splitting of the liver is an effective approach to expand the donor pool and remains an untapped resource for patients in need of liver transplantation. Split graft-to-recipient pairing is crucial for optimal organ allocation and survival outcomes after liver transplantation.
authors.affiliation: The Dumont-UCLA Transplant and Liver Cancer Centers, Pfleger Liver Institute, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, California 90095-7054, USA. johnnyhong@mednet.ucla.edu
authors.forename: Johnny C
authors.initials: JC
authors.lastname: Hong
authors.forename: Hasan
authors.initials: H
authors.lastname: Yersiz
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Busuttil
mesh_terms: D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome