The technology of split liver transplantation is becoming increasingly mature with rapid development. During ex vivo splitting, the depletion of intracellular energy sources [such as adenosine triphosphate (ATP)] and other metabolic disorders may lead to cell damage and dysfunction, which will be aggravated by reperfusion injury of liver transplantation, clinically manifested as postoperative complications and transplantation failure. To further improve the quality of donor liver in ex vivo split liver transplantation, research teams at home and abroad apply machine perfusion to enhance the quality of donor liver. In this article, the research progresses worldwide on machine perfusion of donor liver in ex vivo split liver transplantation were reviewed, and the application and prospect of dual hypothermic oxygenated machine perfusion (D-HOPE) in ex vivo split liver transplantation were elucidated, aiming to provide reference for increasing the source of donor liver for ex vivo split liver transplantation and further resolving the current status of donorliver shortage.

Objective:To perform trans-peritoneal laparoscopic adrenalectomy via a single incision in treatment of adrenal tumors,and to discuss its clinical outcome and safety.Methods:Single incision trans-peritoneal laparoscopic adrenalectomy was used in treatment of three patients with adrenal tumors.The incision was made 3 cm below the costal margin of anterior axillary line; three Tocars were placed in the cut.The instruments used included single port access,CUSA,Hem-o-lok,etc..Results:The three operations were all successful,and there were no conversion to open procedure or a need for extra Ttrocars.The operating time periods were 75,116,and 135 min,with a mean of (108.7?30.7)min.The perioperative blood losses were 10,20,and 30 ml,with a mean of (20?10)ml.The gastric canal and ureteral catheter were withdrew one day after operation,and the drainage tube was withdrew 3 d after operation.The mean postoperative hospital stay was 4 d.Conclusion:Single incision trans-peritoneal laparoscopic adrenalectomy has the advantage of little trauma,less blood loss,satisfactory safety,and prompt postoperative recovery,but is difficult to manage.