Improving outcomes in DCDD liver transplantation: there can only be strength in numbers

Area of Science:

• Hepatology
• Transplantation Surgery
• Organ Donation Research

Background:

• Donation after circulatory determination of death (DCDD) liver transplantation in the US shows lower graft survival than donation after neurological death (DND).
• Liver transplant rates are declining relative to the number of available DCDD donors.
• Existing DCDD protocols may not be sufficient for optimal outcomes.

Purpose of the Study:

• To highlight the challenges in DCDD liver transplantation.
• To propose a collaborative, multi-center approach to improve DCDD liver graft survival.
• To draw parallels with the success of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study.

Main Methods:

• Comparative analysis of DCDD versus DND liver graft survival rates.
• Review of trends in liver transplantation utilizing DCDD donors.
• Exploration of collaborative models in liver transplantation research.

Main Results:

• DCDD liver graft survival remains inferior to DND graft survival.
• There is a concerning trend of decreasing liver transplant rates from DCDD donors.
• Lack of a dedicated multi-center consortium hinders progress in DCDD liver transplantation.

Conclusions:

• Significant improvements in DCDD liver transplantation require a structured, collaborative research effort.
• A consortium approach, similar to adult living donor liver transplantation initiatives, could accelerate innovation.
• Without multi-center collaboration, advancements in DCDD liver transplantation are unlikely to materialize.