Introduction: Orthotopic liver transplantation (OLT) is becoming the only treatment modality for patients with end-stage liver diseases. Because of the limited organ pool, other ways like splitting of the donated liver should be keep in mind. Split liver transplantation (SLT) has been perceived as an important strategy to increase the supply of liver grafts by creating 2 transplants from 1 allograft. The bipartition of a whole liver also carries utmost importance by increasing the available grafts for the pediatric patients, where size-matched whole liver allografts are scarce, leading increased incidence of waiting list mortality in this group. In the common approach of the split liver procedure, liver is divided into a left lateral segment graft (LLS) to be transplanted to a child and a right extended liver lobe graft for an adult recipient but liver may be split to left and right lobes. The liver can be split on the back table (ex situ) or in the donor hospital before the donor cross-clamp using in situ splitting technique The most important advantage of in situ splitting is to decrease the total ischemia time.

Materials and Methods: We analyzed the results of 115patients who underwent split liver transplantation at our center between September 2002 and May 2013 including 55 adults (47%) and 60 children (53%).

Results: One year survival of the recipients was 92%, and 5 year survival was 72%. Pediatric patient survival and graft survival after 1 and 5 years were91% and 72% and 85% and 75%, respectively. Adult patient survival and graft survival after 1 and 5 years were 92% and 71% and88% and 77%, respectively.The most common cause of liver cirrhosis were cryptogenic, biliary atresia, and autoimmune hepatitis.

Conclusions: The use of split liver for adult and pediatric populations allows us to expand the cadaveric donor pool and has the potential to significantly reduce waiting list mortality.