Split-liver transplantation: Past, present, and future

Split-liver transplantation, a procedure in which one cadaver liver is divided to provide for 2 recipients, has existed for over 15 years. Although SLT offers an immediate expansion of the cadaver-donor pool and decreased reliance on living-donation, SLT has not been widely applied within the United States. The continuing shortage of cadaver organs, coupled with the increasing realization of the limits of living donor liver transplantation in adults, has renewed interest in expanding SLT techniques to include 2 adult recipients from one adult cadaver donor. Significant obstacles to the widespread application of SLT exist and must be resolved by the transplant community before greater application of these techniques can be realized. This manuscript reviews current SLT results and how SLT may be further applied to alleviate the current organ shortage.