Successful segmental auxiliary liver transplantation from a non-heart-beating donor: implications for split-liver transplantation

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Abstract
Liver transplantation (LT) using grafts from non–heart-beating donors (NHBDs) has been shown to be a successful practice. Recently reported primary nonfunction rates are similar to those of LT using grafts from brain-dead donors. We report the use of an NHBD liver, which was cut into a right-lobe graft and implanted as an auxiliary partial orthotopic liver transplant for acute liver failure in a 11-year-old child. The warm ischemia time was 21 minutes, and the cold ischemia was 8 hours. Initial graft function was excellent, and the child is well, with normal liver function 2 months posttransplant. Reduction and splitting of livers from NHBDs for transplantation is a realistic option, provided there is careful selection of the graft.