Current Status of Liver Transplant Donors in the United States

Abstract

This report explores the impact of two emerging preservation technologies—Normothermic Regional Perfusion (NRP) and Normothermic Machine Perfusion (NMP)—on liver transplantation outcomes in the United States, particularly for organs donated after circulatory death (DCD). The study highlights that NRP, first introduced in Europe in 2016, has significantly improved DCD liver transplant outcomes, making them comparable to those from brain-dead (BD) donors. In the U.S., following the FDA approval of NMP devices from TransMedics and OrganOx in November 2022, there has been a substantial increase in the acceptance of DCD livers across multiple transplant centers. This has led to a noticeable expansion of the donor pool as Organ Procurement Organizations (OPOs) have actively facilitated DCD donations. While the number of BD donors has slightly decreased, the overall number of transplants for all organs has increased. The adoption of these technologies has not only enhanced organ viability but has also expanded the donor pool, resulting in a notable increase in transplant numbers and helping to address the critical issue of organ shortages in the U.S.