2026-10-11T18:47:34Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33961399 2026-09-22T04:18:15Z category_696 portal_316 item_type_3 month_year_09_2026

Data Sheet 1_Case Report: In situ split liver transplantation from controlled donation after circulatory death donors assisted by normothermic regional perfusion: a case series.pdf Jisan Sun (11405774) Zhiwei Xiong (6994181) Haizhou Hao (25087192) Wentao Jiang (1319004) Genetic Immunology controlled donation after circulatory death normothermic regional perfusion outcomes split liver transplantation case series Introduction<p>Split liver transplantation (SLT) and controlled donation after circulatory death (cDCD) are two strategies used to expand the liver graft pool, but cDCD livers have traditionally been considered unsuitable for splitting because of warm ischemic injury, donor instability, and technical complexity. Normothermic regional perfusion (NRP) can restore oxygenated abdominal perfusion after death declaration and may create a physiologic window for in situ splitting.</p>Case presentation<p>We report two cDCD donation procedures in which NRP supported in situ SLT. Following withdrawal of life-sustaining treatment and death declaration, NRP was initiated before hilar dissection and parenchymal transection. The livers were divided into left lateral segment and right trisegment grafts, which were transplanted into four recipients. Functional donor warm ischemia times were 15 and 20 min, and NRP durations were 154 and 235 min. During NRP, lactate levels decreased substantially in both donors (from 6.6 to 1.2 mmol/L and from 9.5 to 4.1 mmol/L, respectively), with concurrent pH normalization. All recipients had functioning grafts at last follow-up (17.2–20.9 months). One infant developed early allograft dysfunction in association with hepatic artery thrombosis and underwent successful revascularization. No recipient developed primary nonfunction, graft loss, or a clinically diagnosed biliary complication.</p>Conclusion<p>This case series supports the technical feasibility of NRP-assisted in situ SLT from cDCD donors and documents encouraging intermediate-term graft function. The small sample does not establish safety or comparative effectiveness. Larger studies with standardized viability assessment and extended vascular and biliary follow-up are required.</p> 2026-09-22T04:18:15Z Dataset Dataset 10.3389/fimmu.2026.1933200.s002 https://figshare.com/articles/dataset/Data_Sheet_1_Case_Report_In_situ_split_liver_transplantation_from_controlled_donation_after_circulatory_death_donors_assisted_by_normothermic_regional_perfusion_a_case_series_pdf/33961399 CC BY 4.0