The Changing Landscapes in DCD Liver Transplantation

Area of Science:

• Transplantation Medicine
• Hepatology
• Organ Donation

Background:

• Growing disparity between donor liver availability and patient demand for liver transplantation.
• Donation after circulatory death (DCD) liver grafts offer a potential solution to address donor organ shortages.
• The review examines the evolving landscape of DCD liver transplantation (LT).

Purpose of the Study:

• To review the current status and trends in DCD liver transplantation.
• To highlight advancements in DCD LT practices and outcomes.
• To identify persistent challenges and future directions in DCD LT.

Main Methods:

• Analysis of national data on DCD liver transplantations in the USA.
• Review of factors contributing to improved DCD LT outcomes.
• Identification of complications and emerging technologies in DCD LT.

Main Results:

• A consistent annual increase in the number of DCD LTs performed in the USA.
• Demonstrable improvement in patient outcomes following DCD LT.
• Key drivers of improved outcomes include enhanced donor-recipient matching, hemodynamic evaluation, and refined procurement techniques.

Conclusions:

• Ischemic cholangiopathy (IC) remains a significant complication in DCD LT.
• Emerging technologies, such as machine perfusion, show promise for mitigating complications and improving risk assessment for DCD liver grafts.