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Modern-Day Practice of DCD Liver Transplantation: Controversies, Innovations, and Future Directions
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Modern-Day Practice of DCD Liver Transplantation: Controversies, Innovations, and Future Directions
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Journal Article
Modern-Day Practice of DCD Liver Transplantation: Controversies, Innovations, and Future Directions
2023
Overview
Purpose of Review
Over the past decade, donation after circulatory death (DCD) liver transplantation has expanded in the United States due to improved surgical experience and perioperative management. Despite these advances, there remains a reluctance towards broader utilization of DCD liver allografts due to lack of standardized donation process, concern for inferior graft survival, and risk of ischemic cholangiopathy associated with temporary lack of oxygenated perfusion during withdrawal of life-supporting treatment during procurement.
Recent Findings
New perfusion technologies offer potential therapeutic options to mitigate biliary complications and expand utilization of marginal DCD grafts. As these modalities enter routine clinical practice, DCD utilization will continue to increase, and liver allocation policies in turn will evolve to reflect this growing practice.
Summary
This review describes recent progress in DCD LT, current challenges with utilization of DCD liver allografts, and how novel technologies and policies could impact the future of the field.
Publisher
Springer US,Springer Nature B.V
