Graft shortage continues to prolong waiting times for adults requiring live
r transplantation. Living related donor transplantation is possible for onl
y a small minority of adults. The techniques for in situ splitting of the L
iver used for right and left hepatectomies in living donors were adapted to
a combined split-liver-domino procedure to obtain right and left hemiliver
grafts from a patient undergoing total hepatectomy with liver transplantat
ion for a metabolic disorder. The two grafts were adequate in size and func
tion fbr transplantation to two adults with low priority fbr regular cadave
r grafts. More frequent use of split-liver techniques in cadaver donors cou
ld considerably reduce the graft shortage and waiting time for adult liver
recipients. Copyright (C) 2000 by the American Association for the Study of
Liver Diseases.