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Updated: Feb 7, 2026
08:15
Innovative Strategies for Organ Preservation in Heart Transplantation: Uniform Cooling Preservation and Ex-situ Normothermic Perfusion
Published on: November 28, 2025
594
In situ split liver transplantation with celiac trunk allocation: technical evolution and outcomes supporting
Fahim Kanani1,2, Naheel Mahajna1, Aviad Gravetz1
1Department of Transplant Surgery, Rabin Medical Center, Beilinson Hospital, Affiliated to the Gray Faculty of Medicine, Tel Aviv University, Petah Tikva, Israel.
Frontiers in Surgery
|February 6, 2026
Summary
Right-sided split liver transplantation (SLT) with celiac trunk preservation shows favorable vascular outcomes, meeting international benchmarks. This technique is recommended for in situ SLT to expand the donor pool.
Area of Science:
- Hepatobiliary surgery
- Transplantation immunology
- Vascular surgery
Background:
- Split liver transplantation (SLT) is crucial for increasing donor organ availability.
- Optimal arterial reconstruction in SLT remains a subject of debate.
- This study focuses on right-sided in situ SLT with celiac trunk preservation.
Purpose of the Study:
- To evaluate the outcomes of right-sided in situ SLT with celiac trunk preservation.
- To assess vascular and biliary complications, patient and graft survival rates.
- To compare these outcomes with established international benchmarks.
Main Methods:
- Retrospective multicenter analysis of 36 adult recipients undergoing right-sided SLT.
- Data collected from 2015 to 2025.
- Primary outcomes included vascular complications, patient/graft survival, and reoperation rates.
Main Results:
- Major vascular complications occurred in 33% of cases, with Hepatic Artery Thrombosis (HAT) at 2.8% and postoperative Portal Vein Thrombosis (PVT) at 5.6%.
- Biliary complications occurred in 25% of recipients.
- Patient survival rates were 86% at 1 year and 81% at 3 years, with an 11% retransplantation rate.
Conclusions:
- Right-sided SLT with celiac trunk preservation demonstrates excellent vascular outcomes, comparable to international standards.
- The low rates of HAT and PVT support this technique.
- This configuration is strongly advocated as a preferred approach for in situ SLT.
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