{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:55:48Z","timestamp":1780448148182,"version":"3.54.1"},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"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":["Liver International"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Identifying international differences in utilization and outcomes of liver transplantation (LT) after donation after circulatory death (DCD) donation provides a unique opportunity for benchmarking and population\u2010level insight.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult (\u226518\u2009years) LT data between 2008 and 2018 from the UK and US were used to assess mortality and graft failure after DCD LT. We used time\u2010dependent Cox\u2010regression methods to estimate hazard ratios (HR) for risk\u2010adjusted short\u2010term (0\u201390\u2009days) and longer\u2010term (90\u2009days\u20135\u2009years) outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One\u2010thousand five\u2010hundred\u2010and\u2010sixty LT receipts from the UK and 3426 from the US were included. Over the study period, the use of DCD livers increased from 15.7% to 23.9% in the UK compared to 5.1% to 7.6% in the US. In the UK, DCD donors were older (UK:51 vs. US:33\u2009years) with longer cold ischaemia time (UK: 437 vs. US: 333\u2009min). Recipients in the US had higher Model for End\u2010stage Liver Disease (MELD) scores, higher body mass index, higher proportions of ascites, encephalopathy, diabetes and previous abdominal surgeries. No difference in the risk\u2010adjusted short\u2010term mortality or graft failure was observed between the countries. In the longer\u2010term (90\u2009days\u20135\u2009years), the UK had lower mortality and graft failure (adj.mortality HR:UK: 0.63 (95% CI: 0.49\u20130.80); graft failure HR: UK: 0.72, 95% CI: 0.58\u20130.91). The cumulative incidence of retransplantation was higher in the UK (5\u2009years: UK: 11.9% vs. 4.6%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For those receiving a DCD LT, longer\u2010term post\u2010transplant outcomes in the UK are superior to the US, however, significant differences in recipient illness, graft quality and access to retransplantation were seen between the two countries.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15537","type":"journal-article","created":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T05:21:45Z","timestamp":1675488105000},"page":"1107-1119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Outcomes after liver transplantation using deceased after circulatory death donors: A comparison of outcomes in the UK and the US"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1312-4470","authenticated-orcid":false,"given":"Tommy","family":"Ivanics","sequence":"first","affiliation":[{"name":"Multi\u2010Organ Transplant Program University Health Network, University of Toronto"},{"name":"Department of Surgery Henry Ford Hospital  Detroit Michigan USA"},{"name":"Department of Surgical Sciences Akademiska Sjukhuset, Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8218-3119","authenticated-orcid":false,"given":"Marco P. 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W.","family":"Claasen","sequence":"additional","affiliation":[{"name":"Multi\u2010Organ Transplant Program University Health Network, University of Toronto"},{"name":"Department of Surgery, Division of HPB &amp; Transplant Surgery Erasmus MC Transplant Institute, University Medical Centre Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7508-899X","authenticated-orcid":false,"given":"Madhukar S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Surgical Transplantation, Department of Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5019-5497","authenticated-orcid":false,"given":"Emmanouil","family":"Giorgakis","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery University of Arkansas for Medical Sciences  Little Rock Arkansas USA"},{"name":"Hepatopancreatobiliary Surgery, Department of Surgical Oncology Rockefeller Cancer Center Institute, University of Arkansas for Medical Sciences  Little Rock Arkansas USA"},{"name":"Institute of Liver Studies, King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1624-4467","authenticated-orcid":false,"given":"Shirin E.","family":"Khorsandi","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies, King's College Hospital NHS Foundation Trust  London UK"},{"name":"The Roger Williams Institute of Hepatology, Foundation for Liver Research  London UK"},{"name":"Faculty of Life Sciences &amp; Medicine King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3004-1335","authenticated-orcid":false,"given":"Parthi","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies, King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9967-634X","authenticated-orcid":false,"given":"Andreas","family":"Prachalias","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies, King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8193-4889","authenticated-orcid":false,"given":"Krishna","family":"Menon","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies, King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2918-5232","authenticated-orcid":false,"given":"Wayel","family":"Jassem","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies, King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4840-746X","authenticated-orcid":false,"given":"Miriam","family":"Cortes","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies, King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3224-8871","authenticated-orcid":false,"given":"Blayne A.","family":"Sayed","sequence":"additional","affiliation":[{"name":"Multi\u2010Organ Transplant Program University Health Network, University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9215-2014","authenticated-orcid":false,"given":"Amit K.","family":"Mathur","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5392-6323","authenticated-orcid":false,"given":"Kate","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0096-5251","authenticated-orcid":false,"given":"Rhiannon","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"},{"name":"Department of Statistics National Health Service Blood and Transplant  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3462-2188","authenticated-orcid":false,"given":"Nigel","family":"Heaton","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies, King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9476-468X","authenticated-orcid":false,"given":"Neil","family":"Mehta","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-4801","authenticated-orcid":false,"given":"Dorry L.","family":"Segev","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"},{"name":"Department of Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Department of Surgery NYU Grossman School of Medicine and NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5288-5125","authenticated-orcid":false,"given":"Allan B.","family":"Massie","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"},{"name":"Department of Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Department of Surgery NYU Grossman School of Medicine and NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-2335","authenticated-orcid":false,"given":"Jan H. 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