Integration of in situ split procurement and ex situ hyperreduction under dual hypothermic oxygenated perfusion for...

Hypothermic oxygenated machine perfusion may provide a platform for graft manipulation in pediatric liver transplantation. We present an innovative strategy-in situ liver splitting followed by ex situ left lateral segment hyperreduction during dual hypothermic oxygenated perfusion-resulting in successful transplantation in a 2.7-kg neonate with fulminant hepatic failure. This report demonstrates the feasibility of left lateral segment reduction under dual hypothermic oxygenated perfusion and suggests potential advantages of this approach to graft manipulation, unlocking perspectives for pediatric liver transplantation.