Full-right-full-left split liver transplantation: The retrospective analysis of an early multicenter experience including graft sharing

M. Zambelli, E. Andorno, L. De Carlis, G. Rossi, U. Cillo, T. De Feo, A. Carobbio, A. Giacomoni, G. Bottino, M. Colledan

Research output: Contribution to journalArticlepeer-review


Full-right-full-left split liver transplantation divides a donor liver into two grafts to be transplanted in adult-size patients. Major technical and organizational difficulties have limited its application to few single center series. We retrospectively analyzed the long-term results of the first multicenter series of this procedure with graft sharing. Between November 1998 and January 2005, 43 transplants were performed by five centers from 23 full-right-full-left in situ split liver procedures; 65% of the grafts were shared. A total of 31 (72%) patients had complications above grade II; 3 (6.9%) were retransplanted. Hospital mortality was 23% with sepsis as the main cause. Six patients died in the long term, two of them for a road accident. A total of 27 patients are alive after a median follow-up of 3200 days (2035-4256). Actuarial survival at 1 and 10 years were 72.1%, 62.6% and 65.1%, 57.9%, respectively for patients and grafts. These figures are similar to those reported for adult living donor liver transplantation by the European Registry over a similar period. Multicenter collaboration in sharing of these grafts is feasible and can help facing the organizational limits, thus increasing diffusion of full-right-full-left split liver transplantation. Full right and full left grafts from split liver procedures can be shared among different centers of the same area in the context of a collaborative activity, being safely and effectively transplanted in adult patients, thus optimizing the use of deceased donor livers.

Original languageEnglish
Pages (from-to)2198-2210
Number of pages13
JournalAmerican Journal of Transplantation
Issue number8
Publication statusPublished - Aug 2012


  • adult to adult
  • Adults
  • full-right-full-left graft
  • graft sharing
  • partial graft
  • Split liver
  • splitting technique

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)


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