Children’s of Alabama Performs Rare Split-Liver Transplantation in Major Milestone for Pediatric Transplant Care

Birmingham, Ala. (Dec. 5, 2025) - Children’s of Alabama, in collaboration with the University of Alabama at Birmingham Division of Transplantation, has successfully performed a rare split-liver transplantation. This marks the first use of this life-saving technique within the Children’s and UAB partnership in nearly a decade.

Split-liver transplantation, a highly complex procedure, allows a single deceased-donor liver to be divided and transplanted into two recipients located at separate hospitals. This innovative approach expands access to life-saving organs, particularly for pediatric patients who depend on Children’s nationally recognized liver transplant program.

The transplant was led by UAB Assistant Professors of Surgery, Saulat Sheikh, M.B.B.S., and Marcos Pozo Jatem, M.D., working alongside Children’s of Alabama’s multidisciplinary transplant teams. The operation required a coordinated effort across both institutions, incorporating advanced machine perfusion technology to preserve the donor liver and extensive logistical planning for the out-of-state donor operation.

“This achievement represents the culmination of extensive preparation, education, and protocol development across multiple teams,” said Dr. Pozo Jatem, Surgical Director of the Pediatric Liver Transplant Program at Children’s of Alabama. “It involved close collaboration with Pediatric Intensive Care Unit (PICU), hepatology, anesthesiology, pharmacy, nutrition, nephrology, and interventional radiology. It even resulted in the creation of a new intraoperative dialysis protocol to ensure this delicate procedure could be performed safely in critically ill patients.”

Dr. Pozo recognized the contributions of several Children’s and UAB team members whose expertise was essential to the effort, including Meloneysa Hubbard, MSN, CRNP, CCTC, who secured the use of machine normothermic perfusion; patient care coordinators Robin Greer, MSN, CPNP, and Julia Roberson, CRNP; and transplant surgery OR team leader Shannetta Simon, RN.

Additional key contributors from the partnership included David Willcutts, M.D., Assistant Professor of Pediatrics; Jeremy Loberger, M.D., Associate Professor in the PICU; and David Askenazi, M.D., MSPH, Professor of Nephrology.

“The availability of machine perfusion technology is a major advancement,” Dr. Pozo added. “It allows us to accept organs from across the country without increasing cold storage time, helping us maintain the highest possible viability of donated livers.”

According to Dr. Sheikh, who also serves as Surgical Director of UAB’s Living Donor Liver Transplant Program: “This successful split-liver transplantation is a significant milestone and an important step toward expanding access for many more patients on our waitlist. It reflects the extraordinary dedication of our jointly staffed teams at both Children’s of Alabama and UAB.”