Donor
warm ischemia has implications for outcomes after
liver transplantation (LT) using organs from donation after circulatory death (
DCD) donors. Prehospital
cardiac arrest (
PHCA) before donation may generate a further ischemic insult. The aim of this single-center study of 108 consecutive
DCD LT procedures was to compare the outcomes of
PHCA and non-
PHCA cohorts. A review of a prospectively collected database of all
DCD grafts transplanted between January 2007 and October 2011 was undertaken to identify donors who had sustained
PHCA. The unit policy was to consider such donors when
transaminase levels were ≤4 times the normal range and had an improving trend. Twenty-six of the 108
DCD transplants were from
DCD donors with
PHCA, and 82 were in the non-
PHCA cohort. A comparative analysis of the
PHCA and non-
PHCA cohorts showed better short-term results (a low incidence of
acute kidney injury) for the
PHCA group but satisfactory long-term results for both groups with no significant differences in graft or patient survival between them. In conclusion, a careful
donor selection policy for including
PHCA DCD donors with normalized liver function tests or
transaminase levels ≤ 4 times the norm resulted in successful
transplantation and could boost the donor pool with no adverse outcomes.