Extended donors in liver transplantation

Area of Science:

• Organ transplantation
• Transplant immunology
• Graft viability assessment

Background:

• Standard criteria for organ donors are well-established.
• The increasing demand for organ transplants necessitates exploring alternative donor sources.
• Extended criteria donors (ECDs) present unique challenges and opportunities.

Purpose of the Study:

• To review the criteria differentiating standard from extended criteria donors.
• To discuss the implications of incorporating ECDs into transplant programs.
• To highlight strategies for increasing the donor pool and reducing waitlist mortality.

Main Methods:

• Literature review of criteria for donor selection.
• Analysis of factors defining extended criteria donors.
• Examination of the impact of ECDs on transplant outcomes and donor pool size.

Main Results:

• Key criteria for ECDs include deceased after cardiac death donors, advanced donor age, steatosis, prior malignancy, and seropositivity for Hepatitis C virus or Human T-lymphotropic virus.
• Other factors encompass active donor infections, high-risk donor profiles, split liver transplants, and living donor liver transplants.
• Individualized assessment allows for the integration of ECDs into clinical practice.

Conclusions:

• Incorporating extended criteria donors can significantly expand the organ donor pool.
• Individualized assessment and utilization of ECDs can help reduce waitlist mortality.
• The strategic use of ECDs is crucial for meeting the growing demand for organ transplants.