More than 16,000 people in the United States are on the waiting list for a liver transplant, yet 10,000 die before they get one. Cleveland Clinic transplant surgeon Koji Hashimoto has spent the last nine years researching the practice of splitting a donor liver between two recipients, thus reducing demand.

“There’s a big gap between supply and demand,” explains Hashimoto. “In many smaller recipients, the liver is too large. You can’t transplant a large liver into a small patient. So we can split the liver.”

Hashimoto performed split liver transplants in 25 patients in his study, which was published in the July American Journal of Transplantation. Some of Hashimoto’s patients received the left lobe of the liver, some received the right lobe. Two patients benefitted from one liver donated.

“The survival was the same as whole liver transplants,” says Hashimoto. “We’ve had an 80 percent survival rate after five years.”

Only a handful of hospitals are actively performing split liver transplants, with the Cleveland Clinic being one. “Many centers don’t do it because you have to have lots of people on the team and it’s very challenging,” Hashimoto explains. “With a split liver transplant you have two patients receiving livers at the same time. You have to divide the blood vessels too -- sometimes using microscopes in the transplant -- and one surgeon goes out to split the liver in the donor body.”

While the split liver allows surgeons to place an organ in smaller patients, such as children, larger patients benefit as well. “The liver is the only organ that can regenerate in the body,” says Hashimoto. “Eventually the liver will grow to the size to fit the patient.”