Successful Reuse of a Liver Graft in Transplantation: First Reported Case in Chile

Organ donation in Chile remains low, creating a significant shortage of organs for transplantation and leading to long waiting times. A considerable proportion of patients on the liver transplant waiting list do not receive a transplant, often due to clinical deterioration or death. Several strategies exist to expand the organ pool for liver transplantation. The most commonly used approaches include living-donor liver transplantation, splitting a deceased donor liver into two grafts, and utilizing marginal donor grafts. Less frequently employed methods include donation after circulatory death (DCD), domino transplantation, and the reuse of previously transplanted livers. It is also crucial to optimize their utilization by carefully matching them with lower-risk recipients. There are some case reports and small series of cases regarding the successful reuse of liver grafts in the early and late post-transplant periods. We report the first case of the reuse of a deceased donor liver graft in Chile. A 51-year-old woman with fulminant liver failure initially received the graft, which was later donated following her brain death caused by an intracerebral hemorrhage. After undergoing two additional hours of ex situ hypothermic oxygenated perfusion (HOPE), the graft was successfully transplanted into a 55-year-old man with autoimmune hepatitis. The recipient recovered without complications.