Extending liver transplantation: reduced-size-, split-, and living-donor grafts.

The continued shortage of donor liver grafts has made it necessary to find new strategies for obtaining the best possible use of those available. Nowhere is the shortage more acute than in pediatric liver transplantation, where few liver grafts of appropriate size are available to infants and small children in need of transplantation. Initially, strategies were developed to fit larger grafts into smaller recipients. These techniques have been expanded upon, resulting in innovative procedures which increase the number of liver grafts such as living-donor liver transplantation and "split liver" techniques.