Background: Split liver grafting has not gained wide acceptance mainly because of different vascular and biliary technical problems.
Study design: A new technique of right split liver transplantation is described. The piggyback implantation technique, using wide side-to-side cavocavostomy overcomes problems encountered when sharing the superhepatic vena cava cuff between two livers and obtains optimal drainage of venous allograft outflow, thus avoiding extensive bleeding at the transection margin.
Results: This technique was successfully used in two adult recipients.
Conclusions: Piggyback transplantation using wide side-to-side cavocavostomy allows easy and safe implantation of the right split liver allograft.