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Initial outcomes of using allografts from donation after cardiac death donors for liver transplantation in New South Wales

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Despite liver transplantation being an established treatment modality in Australia, there continues to be a significant disparity between donor liver availability and demand.1 One way to reduce this gap is to maximise the use of extended-criteria deceased donor livers, with donation after cardiac death (DCD) being one such option.2 However, the additional warm ischaemia time (WIT) incurred during the DCD donation process has led to a higher reported incidence of complications.3,4

Until recently, all deceased donor liver transplants in Australia were performed with liver allografts retrieved from donors after brain death. However, prior to brain death legislation being established within all jurisdictions, all the early experience in deceased donor organ transplantation was done solely with DCD renal allografts.5 In New South Wales in the 1980s, when transplantation of the other solid organs became a reality with donation after brain death, the practice of DCD renal transplantation all but ceased. All the preliminary experience with liver transplantation in Europe and the United States…