Left and right lobe split-liver transplantation for two paediatric recipients from a 9-year-old donor

Liver splitting increased the number of grafts for paediatric recipients. Usually the two left lateral segments are given to a child and the remaining liver to an adult recipient. Splitting into a right and a left lobe may allow a small adult to benefit from the left lobe while the right lobe goes to another adult recipient. Splitting of paediatric grafts, however, has rarely been performed. We here report on a case where the liver from a 9-year-old donor was ex situ split along the principal fissure creating a right and left lobe which provided grafts for two children aged 2 and 3 years. Immunosuppression consisted of Tacrolimus-based triple drug therapy. Recovery was completely uneventful in both children who are alive and well with normally functioning grafts 11 months following transplantation. These cases demonstrate the feasibility of splitting even paediatric grafts for two small children.