To investigate the clinical effect of in-suit split liver transplantation (ISSLT) from donation after citizen′s death.

The clinical data of 10 cases of ISSLT donors and correlated recipients from May 2015 to February 2017 in Organ Transplantation Center of the Affiliated Hospital of Qingdao University were retrospectively analyzed. Ten donors were all donation after brain death, the median age of donors was 33 years old, 6 cases died of traumatic brain injury and 4 cases died of cerebral hemorrhage, the median body mass index was 22.8 kg/m² and the average time of ICU hospitalization was (3.8±2.1) d. Three kinds of methods were used to split the donor liver and produced 20 grafts which had independent anatomical function. There were 6 pairs of adult - children and 4 pairs of adult-adult in the above 10 cases of ISSLT, and the graft-to-recipient weight ratio were 1.5% to 2.7%.

The average time of in-suit splitting and amount of bleeding were (226±58) min and (138±51) mL, and the median time for donor liver repairment was (84±25) min. Twelve recipients got liver transplantation in our hospital. The median follow-up time of above 12 recipients was 13.5 months up to September 2017. Only 2 recipients occured with biliary complications after transplantation, including 1 case of bile duct mild anastomotic stenosis who improved after percutaneous biliary stenting, and another recipient who received right lobe liver graft had a small amout of bile leakage after T tube clipped 2 weeks after transplantation and improved after drainage.

ISSLT can be developed successfully in circulatory stable brain death donors, which can increased the utilization rate of liver grafts without graft quality reduction.