Extended Criteria Donors (ECD)
Extended Criteria Donor (ECD) is a clinical term for donor livers that fall outside the historical "ideal" donor profile but are still suitable for transplant in the right setting. ECD criteria typically include:
- Older donor age (commonly defined as >60-70 depending on the program)
- Donors with a history of certain treated infections (e.g., hepatitis C, hepatitis B core antibody positive, HIV in HOPE-Act–authorized programs)
- Donors with steatosis (fatty liver) within defined limits
- Donors with longer cold ischemia time
- DCD donors (donation after circulatory death)
Why ECD matters for caregivers:
- Programs that use ECD livers thoughtfully can offer transplants sooner — you spend less time on the waitlist.
- The trade-off is a slightly different post-transplant risk profile, which the center should explain in your evaluation.
- Centers without an active ECD program decline these livers, which can lengthen the wait without necessarily improving outcomes.
Many centers run dedicated protocols for hep C-positive and hep B core antibody-positive donors with antiviral coverage. Ask the coordinator whether your center accepts these and what the post-transplant antiviral plan is.
Educational only — clinician review pending. Not medical advice. Your transplant team has the final word.