biostudies-literatureHaque OAmerican College of Surgeons FoundationAmerican Liver FoundationNational Natural Science Foundation of China-Guangdong Joint FundNIDDK NIH HHSBeijing Nova ProgramNIH Clinical Centere14211https://www.ebi.ac.uk/biostudies/studies/S-EPMC7969458biostudies-literatureUnknown35(3)Compared to donation after brain death (DBD), livers procured for transplantation from donation after circulatory death (DCD) donors experience more ischemia-reperfusion injury and higher rates of ischemic cholangiopathy due to the period of warm ischemic time (WIT) following withdrawal of life support. As a result, utilization of DCD livers for liver transplant (LT) has generally been limited to short WITs and younger aged donor grafts, causing many recovered DCD organs to be discarded without consideration for transplant. This study assesses how DCD liver utilization and outcomes have changed over time, using OPTN data from adult, first-time, deceased donor, whole-organ LTs between January 1995 and December 2019. Results show that increased clinical experience with DCD LT has translated into increased use of livers from DCD donors, shorter ischemic times, shorter lengths of hospitalization after transplant, and lower rates of retransplantation. The data also reveal that over the past decade, the rate of increase in DCD LTs conducted in the United States has outpaced that of DBD. Together, these trends signal an opportunity for the field of liver transplantation to mitigate the organ shortage by capitalizing on DCD liver allografts that are currently not being utilized.Clinical transplantationEvolving utilization of donation after circulatory death livers in liver transplantation: The day of DCD has come.PMC79694581123‐39991 scholarship endowment fund81570679R01DK096075R01 DK107875R01DK107875R01 DK096075Z1611000049161412019 Hans Popper Memorial Postdoctoral FellowHaque OYuan QUygun KMarkmann JFfalseEvolving utilization of donation after circulatory death livers in liver transplantation: The day of DCD has come.Compared to donation after brain death (DBD), livers procured for transplantation from donation after circulatory death (DCD) donors experience more ischemia-reperfusion injury and higher rates of ischemic cholangiopathy due to the period of warm ischemic time (WIT) following withdrawal of life support. As a result, utilization of DCD livers for liver transplant (LT) has generally been limited to short WITs and younger aged donor grafts, causing many recovered DCD organs to be discarded without consideration for transplant. This study assesses how DCD liver utilization and outcomes have changed over time, using OPTN data from adult, first-time, deceased donor, whole-organ LTs between January 1995 and December 2019. Results show that increased clinical experience with DCD LT has translated into increased use of livers from DCD donors, shorter ischemic times, shorter lengths of hospitalization after transplant, and lower rates of retransplantation. The data also reveal that over the past decade, the rate of increase in DCD LTs conducted in the United States has outpaced that of DBD. Together, these trends signal an opportunity for the field of liver transplantation to mitigate the organ shortage by capitalizing on DCD liver allografts that are currently not being utilized.2021-01-01T00:00:00Z2021 Mar2024-11-13T04:30:21.113Z2024-11-13T04:30:21.113ZS-EPMC79694583336870110.1111/ctr.14211