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Semin Liver Dis 2020; 40(03): 256-263
DOI: 10.1055/s-0040-1709487
Review Article

Donation after Circulatory Death: Potential Mechanisms of Injury and Preventative Strategies

Kristopher P. Croome
1   Department of Transplant, Mayo Clinic Florida, Jacksonville, Florida
› Author Affiliations Funding The manuscript did not receive any funding.
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Abstract

Donation after circulatory death (DCD) donors represent a potential means to help address the disparity between the number of patients awaiting liver transplantation (LT) and the availability of donor livers. While initial enthusiasm for DCD LT was high in the early 2000s, early reports of high rates of biliary complications and inferior graft survival resulted in reluctance among many transplant centers to use DCD liver grafts. As with all innovations in transplant practice, there is undoubtedly a learning curve associated with the optimal utilization of liver grafts from DCD donors. More contemporary data has demonstrated that results with DCD LT are improving and the number of DCD LT performed annually has been steadily increasing. In this concise review, potential mechanisms of injury for DCD livers are discussed along with strategies that have been employed in clinical practice to improve DCD LT outcomes.

Keywords

DCD - nonheart beating - ischemic cholangiopathy - microthrombi - tPA - donation after circulatory death


Publication History

Article published online:
18 June 2020

© 2020. Thieme. All rights reserved.

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