Published online Nov 18, 2015. doi: 10.4254/wjh.v7.i26.2636
Peer-review started: May 20, 2015
First decision: July 25, 2015
Revised: October 4, 2015
Accepted: November 3, 2015
Article in press: November 4, 2015
Published online: November 18, 2015
Liver transplantation is the treatment of choice for end stage liver disease, but availability of liver grafts is still the main limitation to its wider use. Extended criteria donors (ECD) are considered not ideal for several reasons but their use has dramatically grown in the last decades in order to augment the donor liver pool. Due to improvement in surgical and medical strategies, results using grafts from these donors have become acceptable in terms of survival and complications; nevertheless a big debate still exists regarding their selection, discharge criteria and allocation policies. Many studies analyzed the use of these grafts from many points of view producing different or contradictory results so that accepted guidelines do not exist and the use of these grafts is still related to non-standardized policies changing from center to center. The aim of this review is to analyze every step of the donation-transplantation process emphasizing all those strategies, both clinical and experimental, that can optimize results using ECD.
Core tip: This review analyzes the donation-transplantation process when using extended criteria donors. Every step, from donor selection to transplantation, is discussed emphasizing experimental and clinical strategies that can lead to optimize results.