How to apply ex-vivo split liver transplantation safely and feasibly: A three-step approach

Figure 3 Procedure of liver parenchymal division. A: Identification of the landmark line on the visceral surface of the liver for liver parenchymal division (0.5-1.0 cm to the right of the liver round ligament); B: Landmark line on the diaphragmatic surface of the liver for liver parenchymal division (on the right of the falciform ligament); C: Liver parenchymal division in the flat position, using titanium clips for small vessels (arrow); D: Adjusting the position of the liver during parenchymal division (suprahepatic inferior vena cava facing upwards), using silk sutures or ligatures for larger vessels (arrow); E: Continued liver parenchymal division with the liver flipped (suprahepatic inferior vena cava facing downward); F: Display of the two smooth liver segment surfaces after completion of the splitting process (arrow).