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The split liver technique enables transplanting 2 recipients with one single graft (typically an adult-child pair). It facilitates small recipients' access to liver transplantation and reduces mortality on the waiting list. However, splitting is technically demanding and may increase peri- and postoperative complications. To be able to obtain comparable outcomes to a full graft liver transplantation, careful donor-recipients selection, experienced surgeons, and logistic planning are paramount. The video shows an in situ split liver procedure from a 32-year-old brain stem death donor to generate a left lateral sector for a child and a right extended graft for an adult recipient.

The demand for older patients not to be denied access to liver transplantation (LT) has intensified as the European population continues to live longer and maintains better health.This study aims to ascertain the impact of recipient age on the post-LT survival in 2 well-balanced populations at Vall d'Hebron University Hospital.From January 1990 to December 2016, LT recipients (young group: 50-65 years of age; elderly group:65 years of age) were compared by means of a propensity score matching (PSM) method.Prior to PSM, graft survival and patient survival were worse for the elderly group (P .001). In 1126 LT recipients, a caliper width of 0.01 was used based on the donor (age, sex, cause of donor death, and donor intensive care unit stay) and recipient covariates (sex, body mass index, indication for LT, intraoperative blood transfusion, cardiovascular risk factors, and Model for End-Stage Liver Disease [MELD]-Era). After PSM, 206 patients were matched; 1-, 5-, and 10-year patient survival rates were 77%, 63%, and 52% vs 80%, 64%, and 45% (P = .50) for young vs elderly recipients, respectively. Similar graft survival rates were observed in both groups (P = .42).Advanced age alone should not exclude patients from LT.

S OME patients do not tolerate inferior vena cava (NC) and portal clamping during the anhepatic phase of orthotopic liver transplantation (OLT), and veno-venous bypass (VVBP) is usually required in order to maintain hemodynamics during this phase.’ Recipient hepatectomy with IVC preservation’ was introduced into our program in 1991 to avoid WBP and complications due to its use. This technique became routine in the majority of cases.3 The aim of this study was to ratify our results by measuring I?C flow and pressure and correlating them with data on patient hemodynamics.