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However, DCD organs experience long\u2010term damage caused by warm ischemia (WI) and microthrombosis caused by diffuse intravascular coagulation. Unfortunately, because of concerns about post\u2010transplantation complications, most organs considered high\u2010risk are discarded, resulting in wasted medical resources and economic losses. However, thrombolytic therapy before transplantation may dissolve microthrombosis in DCD organs, improve organ microcirculation, and increase organ use. Herein, we review the current status and potential value of thrombolytic therapy before DCD organ transplantation, summarize the progress of thrombolytic therapy for DCD organ transplantation according to preclinical and clinical research, and emphasize the heterogeneity and limitations of studies that have caused some controversies associated with this therapy. Overall, the role of thrombolytic therapy should not be overlooked. We anticipate that thrombolytic therapy combined with machine perfusion will provide an opportunity to improve inferior\u2010quality DCD grafts, resulting in their becoming more widely available and safer for transplantation, thus solving the urgent problem of organ shortage.<\/jats:p>","DOI":"10.1111\/ctr.70099","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T01:22:24Z","timestamp":1739236944000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Advances and Challenges of Thrombolytic Therapy for Donation After Circulatory Death Organs"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3859-0937","authenticated-orcid":false,"given":"Peng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of General Surgery Division of Hepatobiliary and Pancreas Surgery Shenzhen People's Hospital (The Second Clinical Medical College Jinan University The First Affiliated Hospital Southern University of Science and Technology)  Shenzhen P.R. 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