{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T12:45:21Z","timestamp":1782737121202,"version":"3.54.5"},"reference-count":31,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Scientific Research Fund of Zhejiang Provincial Education Department","award":["Y202250768"],"award-info":[{"award-number":["Y202250768"]}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The most effective treatment for end-stage liver diseases is liver transplantation, which is impeded by the shortage of donor livers. Split liver transplantation (SLT) is important for addressing the donor liver shortage. However, full-right full-left SLT for two adult recipients is globally rarely conducted. This study aimed to investigate the clinical outcomes of this technique. Methods: We retrospectively analyzed the clinical data of 22 recipients who underwent full-right full-left SLT at Shulan (Hangzhou) Hospital between January, 2021 and September, 2022. The graft-to-recipient weight ratio (GRWR), cold ischemia time, operation time, length of the anhepatic phase, intraoperative blood loss, and red blood cell transfusion amount were all analyzed. The differences in liver function recovery after transplantation were compared between the left and right hemiliver groups. The postoperative complications and prognosis of the recipients were also analyzed. Results: The livers of 11 donors were transplanted into 22 adult recipients. The GRWR ranged from 1.16\u20131.65%, the cold ischemia time was 282.86 \u00b1 134.87 min, the operation time was 371.32 \u00b1 75.36 min, the anhepatic phase lasted 60.73 \u00b1 19.00 min, the intraoperative blood loss was 759.09 \u00b1 316.84 mL, and the red blood cell transfusion amount was 695.45 \u00b1 393.67 mL. No significant difference in the levels of liver function markers, total bilirubin, aspartate aminotransferase, or alanine aminotransferase between left and right hemiliver groups at 1, 3, 5, 7, 14, and 28 d postoperatively was observed (both p &gt; 0.05). One recipient developed bile leakage 10 d after transplantation, which improved with endoscopic retrograde cholangiopancreatography-guided nasobiliary drainage and stent placement. Another developed portal vein thrombosis 12 d after transplantation and underwent portal vein thrombolytic therapy and stenting to restore portal vein blood flow. A color Doppler ultrasound performed 2 d after transplantation revealed hepatic artery thrombosis in one patient, and thrombolytic therapy was administered to restore hepatic artery blood flow. The liver function of other patients recovered quickly after transplantation. Conclusions: Full-right full-left SLT for two adult patients is an efficient way to increase the donor pool. It is safe and feasible with careful donor and recipient selection. Transplant hospitals with highly experienced surgeons in SLT are recommended to promote using full-right full-left SLT for two adult recipients.<\/jats:p>","DOI":"10.3390\/jcm12113782","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T04:41:49Z","timestamp":1685508109000},"page":"3782","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Full-Right Full-Left Split Liver Transplantation for Two Adult Recipients: A Single-Center Experience in China"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0437-5008","authenticated-orcid":false,"given":"Limin","family":"Ding","sequence":"first","affiliation":[{"name":"Division of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"},{"name":"NHFPC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou 310003, China"},{"name":"Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, CAMS, Hangzhou 310003, China"},{"name":"Key Laboratory of Organ Transplantation, Hangzhou 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xizhi","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"},{"name":"NHFPC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou 310003, China"},{"name":"Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, CAMS, Hangzhou 310003, China"},{"name":"Key Laboratory of Organ Transplantation, Hangzhou 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Fuzhou Medical College, Nanchang University, Fuzhou 344000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie","family":"Qian","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"},{"name":"NHFPC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou 310003, China"},{"name":"Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, CAMS, Hangzhou 310003, China"},{"name":"Key Laboratory of Organ Transplantation, Hangzhou 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou 310022, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinchuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"},{"name":"NHFPC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou 310003, China"},{"name":"Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, CAMS, Hangzhou 310003, China"},{"name":"Key Laboratory of Organ Transplantation, Hangzhou 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhou","sequence":"additional","affiliation":[{"name":"NHFPC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou 310003, China"},{"name":"Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, CAMS, Hangzhou 310003, China"},{"name":"Key Laboratory of Organ Transplantation, Hangzhou 310003, China"},{"name":"Collaborative Innovation Center for Diagnosis Treatment of Infectious Diseases, Hangzhou 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou 310022, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1459-8261","authenticated-orcid":false,"given":"Shusen","family":"Zheng","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"},{"name":"NHFPC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou 310003, China"},{"name":"Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, CAMS, Hangzhou 310003, China"},{"name":"Key Laboratory of Organ Transplantation, Hangzhou 310003, China"},{"name":"Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou 310022, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.1111\/tri.14160","article-title":"Full-left-full-right split liver transplantation for adult recipients: A systematic review and meta-analysis","volume":"34","author":"Sneiders","year":"2021","journal-title":"Transpl. 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Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e304","DOI":"10.3346\/jkms.2020.35.e304","article-title":"Prognosis of split liver transplantation compared with whole liver transplantation in adult patients: Single-center results under the Korean MELD score-based allocation policy","volume":"35","author":"Park","year":"2020","journal-title":"J. Korean Med. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kong, L., Lv, T., Jiang, L., Yang, J., and Yang, J. (2020). Outcomes of hemi-versus whole liver transplantation in patients from mainland china with high model for end-stage liver disease scores: A matched analysis. 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