An update on usage of high-risk donors in liver transplantation

Muhammad H., Zaffar D., Tehreem A., Ting P., ŞİMŞEK C., Turan I., ...More

Journal of Clinical Medicine, vol.11, no.1, 2022 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Review
  • Volume: 11 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.3390/jcm11010215
  • Journal Name: Journal of Clinical Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, Directory of Open Access Journals
  • Keywords: Donors after cardiac death, HIV Organ Policy Equity (HOPE) Act, Liver transplantation, Split liver, Steatotic donors
  • Hacettepe University Affiliated: Yes


The ideal management for end stage liver disease, acute liver failure, and hepatocellular carcinoma (HCC), within specific criteria, is liver transplantation (LT). Over the years, there has been a steady increase in the candidates listed for LT, without a corresponding increase in the donor pool. Therefore, due to organ shortage, it has been substantially difficult to reduce waitlist mortality among patients awaiting LT. Thus, marginal donors such as elderly donors, steatotic donors, split liver, and donors after cardiac death (DCD), which were once not commonly used, are now considered. Furthermore, it is encouraging to see the passing of Acts, such as the HIV Organ Policy Equity (HOPE) Act, enabling further research and development in utilizing HIV grafts. Subsequently, the newer antivirals have aided in successful post-transplant period, especially for hepatitis C positive grafts. However, currently, there is no standardization, and protocols are center specific in the usage of marginal donors. Therefore, studies with longer follow ups are required to standardize its use.