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BioMed Research International
Volume 2018, Article ID 1756069, 8 pages
Review Article

Donation after Circulatory Death in Paediatric Liver Transplantation: Current Status and Future Perspectives in the Machine Perfusion Era

1Division of Abdominal Transplantation and Hepatobiliopancreatic Surgery, Bambino Gesù Children’s Research Hospital IRCCS, Rome, Italy
2The Liver Unit, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
3Department of Experimental Medicine and Surgery, Liver Unit, Tor Vergata University of Rome, Rome, Italy

Correspondence should be addressed to Roberta Angelico; moc.liamg@ocilegna.atrebor

Received 21 November 2017; Accepted 14 February 2018; Published 18 March 2018

Academic Editor: Riccardo De Carlis

Copyright © 2018 Roberta Angelico et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Efforts have been made by the transplant community to expand the deceased donor pool in paediatric liver transplantation (LT). The growing experience on donation after circulatory death (DCD) for adult LT has encouraged its use also in children, albeit in selective cases, opening new perspectives for paediatric patients. Even though there has recently been a slight increase in the number of DCD livers transplanted in children, with satisfactory graft and patient outcomes, the use of DCD grafts in paediatric recipients is still controversial due to morbid outcomes associated with DCD grafts. In this context, recent advances in the optimization of donor support by extracorporeal membrane oxygenation and in the graft preservation by liver machine perfusion could find application in order to expand the donor pool in paediatric LT. In the present study we review the current literature on DCD liver grafts transplanted in children and on the use of extracorporeal donor support and liver perfusion machines in paediatrics, with the aim of defining the current status and future perspectives of paediatric LT.