Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Dec;25(12):413-420.
doi: 10.1007/s11894-023-00902-8. Epub 2023 Oct 28.

Modern-Day Practice of DCD Liver Transplantation: Controversies, Innovations, and Future Directions

Omar J Haque  1 , Eve M Roth  1 , David D Lee  2
Affiliations
Review

Modern-Day Practice of DCD Liver Transplantation: Controversies, Innovations, and Future Directions

Omar J Haque et al. Curr Gastroenterol Rep. 2023 Dec.

Abstract

Purpose of review: Over the past decade, donation after circulatory death (DCD) liver transplantation has expanded in the United States due to improved surgical experience and perioperative management. Despite these advances, there remains a reluctance towards broader utilization of DCD liver allografts due to lack of standardized donation process, concern for inferior graft survival, and risk of ischemic cholangiopathy associated with temporary lack of oxygenated perfusion during withdrawal of life-supporting treatment during procurement.

Recent findings: New perfusion technologies offer potential therapeutic options to mitigate biliary complications and expand utilization of marginal DCD grafts. As these modalities enter routine clinical practice, DCD utilization will continue to increase, and liver allocation policies in turn will evolve to reflect this growing practice. This review describes recent progress in DCD LT, current challenges with utilization of DCD liver allografts, and how novel technologies and policies could impact the future of the field.

Keywords: Donation after Circulatory Death; Liver Transplantation; Normothermic Machine Perfusion; Normothermic Regional Perfusion.

PubMed Disclaimer

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Thuong M, Ruiz A, Evrard P, et al. New classification of donation after circulatory death donors definitions and terminology. Transpl Int Off J Eur Soc Organ Transplant. 2016;29(7):749–59.
    1. Foley DP, Fernandez LA, Leverson G, et al. Donation after cardiac death: the University of Wisconsin experience with liver transplantation. Ann Surg. 2005;242(5):724–31. - DOI - PubMed - PMC
    1. Skaro AI, Jay CL, Baker TB, et al. The impact of ischemic cholangiopathy in liver transplantation using donors after cardiac death: the untold story. Surg. 2009;146(4):543–52 (discussion 552–553). - DOI
    1. Jay C, Ladner D, Wang E, et al. A comprehensive risk assessment of mortality following donation after cardiac death liver transplant - an analysis of the national registry. J Hepatol. 2011;55(4):808–13. - DOI - PubMed - PMC
    1. Haque O, Yuan Q, Uygun K, Markmann JF. Evolving utilization of donation after circulatory death livers in liver transplantation: The day of DCD has come. Clin Transplant. 2021;35(3): e14211. - DOI - PubMed - PMC

LinkOut - more resources