Cold ischemia time in liver transplantation: An overview

Figure 1 The different phases during liver procurement and transplantation. In donation after brain death donor, warm ischemia time (WIT) is very short, and it starts at the time of cross clamping until flush of cold perfusion. Donation after circulatory death donor is more complex: WIT starts when either SpO₂ or blood pressure drop below a certain threshold and lasts until the start of cold perfusion or the start of normothermic regional perfusion. For every donor, cold ischemia time (CIT) starts at cold perfusion, after aortic cross-clamp, and continues during graft removal, graft transportation and back table preparation until removal from ice for implantation in the recipient. Transport time is a part of CIT unless the organ undergoes some form of normothermic organ perfusion. CIT: Cold ischemia time; DBD: Donation after brain death; DCD: Donation after circulatory death.