Results of in situ splitting

Orthotopic liver transplantation (OLT) has become a well-established therapeutic modality for patients with end stage liver disease. Improvements in the management of patients, as well as advances in immunosuppression and surgical technique have accounted for remarkable progress in the nearly four decades since the first OLT was performed in 1963 [1,2]. The full potential for liver replacement is far from being realized because of the widening disparity between rapidly increasing numbers of potential recipients and a severely insufficient cadaveric organ donor supply. Currently, in the United States, it is estimated that more than 15,000 patients are listed for liver transplantation with only 4500 cadaveric livers available annually. With more than 4 million Americans affected with hepatitis C, 25–35% of whom will develop cirrhosis, the transplant community is anticipating an epidemic of patients requiring transplantation. This increasing discrepancy between donor supply and potential recipients has resulted in rising mortality of adult and pediatric patients awaiting OLT.