[Expanding the liver donor pool through extended-criteria donation]

Due to the great shortage of donor organs in liver transplantation, the utilization of liver allografts from extended-criteria donors is gaining importance. An accepted precise definition of extended-criteria donors remains elusive. The most frequent criteria include high donor age, graft steatosis, and prolonged ICU stay. The influence of using extended-criteria donors on post-transplant outcome has yet to be defined. Its possibly higher rates of graft dysfunction and impaired graft and recipient survival are countered by a proven reduction in waiting-list mortality. Moreover, recipient factors of particular risk such as high MELD (model for endstage liver disease) score and underlying hepatitis C infection have to be defined and taken into consideration.