{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:47:52Z","timestamp":1787500072942,"version":"build-2736575974"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T00:00:00Z","timestamp":1635552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Donation after circulatory death (DCD) is an increasingly utilized alternative to donation after brain death (DBD) to expand the liver donor pool. We compared the outcomes of liver transplant (LT) after DCD versus DBD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A PRISMA\u2010compliant systematic literature review was performed using the PubMed, Cochrane Library, and Embase databases (end\u2010of\u2010search\u2010date: July 2, 2020). US outcomes were analyzed using the UNOS database (February, 2002\u2013September, 2020). Pooled hazard ratios (HR) for patient and graft survival were obtained through random effect meta\u2010analyses and adjusted for publication bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen studies reporting on 1426 DCD and 5385 DBD LT recipients were included. 5620 DCD and 87561 DBD LT recipients were analyzed from the UNOS database. Meta\u2010analysis showed increased risk of patient mortality for DCD (HR\u00a0=\u00a01.36; 95%CI, 1.09\u20131.70;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\u00a0.01;\n                      <jats:italic>\n                        I\n                        <jats:sup>2\u00a0<\/jats:sup>\n                      <\/jats:italic>\n                      =\u00a053.6%). When adjusted for publication bias, meta\u2010analysis showed no difference in patient survival between DCD and DBD (HR\u00a0=\u00a01.15; 95%CI, .91\u20131.45;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\u00a0.25;\n                      <jats:italic>\n                        I\n                        <jats:sup>2\u00a0<\/jats:sup>\n                      <\/jats:italic>\n                      =\u00a061.5%). Meta\u2010analysis showed increased risk of graft loss for DCD (HR\u00a0=\u00a01.50; 95%CI, 1.20\u20131.88;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      &lt;\u00a0.001;\n                      <jats:italic>\n                        I\n                        <jats:sup>2\u00a0<\/jats:sup>\n                      <\/jats:italic>\n                      =\u00a067.8%). When adjusted for publication bias, meta\u2010analysis showed a reduction in effect size (HR\u00a0=\u00a01.36; 95%CI, 1.06\u20131.74;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\u00a0.02;\n                      <jats:italic>\n                        I\n                        <jats:sup>2\u00a0<\/jats:sup>\n                      <\/jats:italic>\n                      =\u00a073.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>When adjusted for publication bias, no difference was identified between DCD and DBD regarding patient survival, while DCD was associated with an increased risk of graft loss.<\/jats:p>\n                  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