title: Potential approaches to improve the outcomes of donation after cardiac death liver grafts.
abstract: There is a growing discrepancy between the supply and demand of livers for transplantation resulting in high mortality rates on the waiting list. One of the options to decrease the mortality on the waiting list is to optimize organs with inferior quality that otherwise would be discarded. Livers from donation after cardiac death (DCD) donors are frequently discarded because they are exposed to additional warm ischemia time, and this might lead to primary-non-function, delayed graft function, or severe biliary complications. In order to maximize the usage of DCD livers several new preservation approaches have been proposed. Here, we will review 3 innovative organ preservation methods: (1) different ex vivo perfusion techniques; (2) persufflation with oxygen; and (3) addition of thrombolytic therapy. Improvement of the quality of DCD liver grafts could increase the pool of liver graft's for transplantation, improve the outcomes, and decrease the mortality on the waiting list.
authors.affiliation: Paria Mahboub, Department of Surgery, Groningen Transplant Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
authors.forename: Paria
authors.initials: P
authors.lastname: Mahboub
authors.affiliation: Paria Mahboub, Department of Surgery, Groningen Transplant Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
authors.forename: Adel
authors.initials: A
authors.lastname: Bozorgzadeh
authors.affiliation: Paria Mahboub, Department of Surgery, Groningen Transplant Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
authors.forename: Paulo N
authors.initials: PN
authors.lastname: Martins
keywords: Biliarycomplications; Donation after cardiac death; Organ preservation methods