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Living and cadaveric split-liver donation: methods of overcoming a shortage in liver transplantation

The quest to solve the cadaveric liver graft shortage has met two surgical innovations that expand the donor pool: split-liver transplantation and living-donor liver transplantation. These procedures in the surgical armamentarium allow two transplantable grafts to be obtained from a single donor (split-liver transplantation) and a reduced-size liver to be obtained from a living donor. These technical innovations reduce the death rate of patients on the waiting list. This article summarizes the most recent publications in this field, focussing on patient selection, controversial surgical aspects, and overall results in adult liver transplantation.