Abstract
Although biliary complications are likely the most acknowledged and studied morbid complication associated with the use of donation after circulatory death (DCD) grafts, the scope of the issues with DCD livers extends beyond the bile duct to include post-reperfusion syndrome, overall graft dysfunction (both primary non-function and early allograft dysfunction), renal dysfunction (acute kidney injury and end-stage renal disease), and vascular complications (microthrombi, hepatic artery stenosis, hepatic artery thrombosis). This chapter covers the current incidence rates of these non-biliary complications in liver grafts from DCD donors in several large-center studies, both in isolation and in comparison to donation after brain death (DBD) liver grafts. Additionally, it briefly describes new modeling systems to better assess these complications and potential modalities to mitigate some of these issues.