DCD vs. Brain Death (DBD) Donors
Two donor pathways supply most of the deceased-donor liver pool.
Donation after Brain Death (DBD)
- The donor has been declared dead by neurologic criteria; the heart is still beating at organ recovery.
- Historically the "standard" donor pathway for liver transplant.
- Most published outcomes data references DBD donors.
Donation after Circulatory Death (DCD)
- The donor has been declared dead by circulatory criteria — the heart has stopped before recovery.
- Liver is exposed to a period of warm ischemia between cardiac arrest and recovery, which is the main clinical concern.
- DCD donors expand the donor pool but require careful selection and often modern preservation (HOPE or NMP).
Why this matters for caregivers:
- Programs with active DCD use can offer you a transplant sooner — there are simply more livers available.
- DCD outcomes have improved substantially with HOPE perfusion and NMP, narrowing the historical gap with DBD.
- A program that does not accept DCD livers may have longer waits without offsetting benefit.
Ask: "Do you accept DCD livers, and what's your protocol — HOPE, NMP, or standard cold storage?"
Educational only — clinician review pending. Not medical advice. Your transplant team has the final word.