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Use of Extended Criteria Deceased Donors in Adult Liver Transplantation

  • Solid Organ Transplantation (C Sonnenday, Section Editor)
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Abstract

Reflective of the gross national shortage of organs available for transplantation, utilization of extended criteria donor livers has gained momentum, arguing the merits of transplantation with higher risk organs outweighs the risks associated with staying on the waiting list. As a result, high-risk extended criteria allografts, previously referred to as marginal or compromised organs, have become an important part of the donor organ supply. Unfortunately, the use of “expanded” criteria liver allografts remains undefined. Therefore, due to regional heterogeneity in the landscape of national scarcity, allocation policies for extended criteria allografts have largely been transplant center specific and calibrated based on predicted recipient benefit, projected reduction in waitlist mortality, and parity. The utility, selection, and performance of “extended criteria” donor allograft livers are examined in this review.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Renz JF, Kin C, Kinkhabwala M, Jan D, Varadarajan R, Goldstein M, et al. Utilization of extended donor criteria liver allografts maximizes donor use and patient access to liver transplantation. Ann Surg. 2005;242(4):556–63.

    PubMed Central  PubMed  Google Scholar 

  2. Ozhathil DK, Li YF, Smith JK, Tseng JF, Saidi RF, Bozorgzadeh A, et al. Impact of center volume on outcomes of increased-risk liver transplants. Liver Transplant. 2011;17(10):1191–9. doi:10.1002/lt.22343.

    Article  Google Scholar 

  3. Cescon M, Grazi GL, Ercolani G, Nardo B, Ravaioli M, Gardini A, et al. Long-term survival of recipients of liver grafts from donors older than 80 years: is it achievable? Liver Transplant. 2003;9(11):1174–80.

    Article  Google Scholar 

  4. Segev DL, Thompson RE, Locke JE, Simpkins CE, Thuluvath PJ, Montgomery RA, et al. Prolonged waiting times for liver transplantation in obese patients. Ann Surg. 2008;248(5):863–70. doi:10.1097/SLA.0b013e31818a01ef.

    Article  PubMed  Google Scholar 

  5. Stewart ZA, Locke JE, Segev DL, Dagher NN, Singer AL, Montgomery RA, et al. Increased risk of graft loss from hepatic artery thrombosis after liver transplantation with older donors. Liver Transplant. 2009;15(12):1688–95. doi:10.1002/lt.21946.

    Article  Google Scholar 

  6. Bechstein WO. Older livers–should they be used for transplantation? J Hepatol. 2004;41(3):485–7.

    Article  PubMed  Google Scholar 

  7. Workgroup on expanded criteria organs for liver transplantation. Liver Transplant. 2005;11(10):1184–92. doi:10.1002/lt.20569.

    Article  Google Scholar 

  8. Feng S, Goodrich NP, Bragg-Gresham JL, Dykstra DM, Punch JD, DebRoy MA, et al. Characteristics associated with liver graft failure: the concept of a donor risk index. Am J Transplant. 2006;6(4):783–90.

    Article  CAS  PubMed  Google Scholar 

  9. Berg CL, Steffick DE, Edwards EB, Heimbach JK, Magee JC, Washburn WK, et al. Liver and intestine transplantation in the United States 1998–2007. Am J Transplant. 2009;9(4 Pt 2):907–31. doi:10.1111/j.1600-6143.2009.02567.x.

    Article  CAS  PubMed  Google Scholar 

  10. Hayashi PH, Axelrod DA, Galanko J, Salvalaggio PR, Schnitzler M. Regional differences in deceased donor liver transplantation and their implications for organ utilization and allocation. Clin Transplant. 2011;. doi:10.1111/j.1399-0012.2010.01214.x.

    Google Scholar 

  11. Barshes NR, Becker NS, Washburn WK, Halff GA, Aloia TA, Goss JA. Geographic disparities in deceased donor liver transplantation within a single UNOS region. Liver Transplant. 2007;13(5):747–51. doi:10.1002/lt.21158.

    Article  Google Scholar 

  12. Maluf DG, Stravitz RT, Cotterell AH, Posner MP, Nakatsuka M, Sterling RK, et al. Adult living donor versus deceased donor liver transplantation: a 6-year single center experience. Am J Transplant. 2005;5(1):149–56.

    Article  PubMed  Google Scholar 

  13. Schaubel DE, Sima CS, Goodrich NP, Feng S, Merion RM. The survival benefit of deceased donor liver transplantation as a function of candidate disease severity and donor quality. Am J Transplant. 2008;8(2):419–25. doi:10.1111/j.1600-6143.2007.02086.x.

    Article  CAS  PubMed  Google Scholar 

  14. Pereira B, Milford E, Kirkman R. Prevalence of HCV RNA in hepatitis C antibody positive cadaver organ donors and their recipients. N Engl J Med. 1992;327:910–5.

    Article  CAS  PubMed  Google Scholar 

  15. Dominguez-Gil B, Morales JM. Transplantation in the patient with hepatitis C. Transpl Int. 2009;22:1–15.

    Article  Google Scholar 

  16. Terraul NA, Shiffman ML, Lok AS, Saab S, Tong L, Brown RS, et al. Outcomes in hepatitis C virus-infected recipients of living donor vs. deceased donor liver transplantation. Liver Transplant. 2007;13:122–9.

    Article  Google Scholar 

  17. Vargas HE, Laskus T, Wang L-F, Lee R, Radkowski M, Dodson F, et al. Outcome of liver transplantation in hepatitis C virus-infected patients who received hepatitis C virus-infected grafts. Gastroenterology. 1999;117:149–53.

    Article  CAS  PubMed  Google Scholar 

  18. Testa G, Vidanovic V, Chejfec G, Ganemi A, Iqpal R, Porubsky M, et al. Adult living-donor liver transplantation with ABO-incompatible grafts. Clin Transplant. 2008;85(5):681–6.

    Article  Google Scholar 

  19. Velidedeoglu E, Desai NM, Campos L, Olthoff KM, Shaked A, Nunes F, et al. The outcome of liver grafts procured from hepatitis C-positive donors. Transplantation. 2002;73(4):582–7.

    Article  PubMed  Google Scholar 

  20. Ghobrial RM, Steadman R, Gornbein J, Lassman C, Holt CD, Chen P, et al. A 10-Year experience of liver transplantation for hepatitis C: analysis of factors determining outcome in over 500 patients. Ann Surg. 2001;234(3):384–94.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Burr AT, Li Y, Tseng JF, Saidi RF, Bozorgzadeh A, Shah SA. Survival after liver transplantation using hepatitis C virus-positive donor allografts: case-controlled analysis of the UNOS database. World J Surg. 2011;35(7):1590–5. doi:10.1007/s00268-011-1019-5.

    Article  PubMed  Google Scholar 

  22. Gutierrez JA, Carrion AF, Avalos D, O’Brien C, Martin P, Bhamidimarri KR, et al. Sofosbuvir and simeprevir for treatment of hepatitis C virus infection in liver transplant recipients. Liver Transplant. 2015. doi:10.1002/lt.24126.

    Google Scholar 

  23. Rahimi RS, O’Leary JG. Post-liver transplant hepatitis C therapy. Curr Treat Options Gastroenterol. 2015;13(2):249–58. doi:10.1007/s11938-015-0051-1.

    Article  PubMed  Google Scholar 

  24. • Verna EC, Saxena V, Burton JR, Jr., O’Leary JG, Dodge JL, Stravitz RT et al. Telaprevir- and boceprevir-based triple therapy for hepatitis C in liver transplant recipients with advanced recurrent disease: a multicenter study. Transplantation. 2015. doi:10.1097/TP.0000000000000629. Novel study describing the effectiveness of HCV therapy after liver transplant.

  25. Dickson RC, Everhart JE, Lake JR, Wei Y, Seaberg EC, Wiesner RH, et al. Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen. The National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database. Gastroenterology. 1997;113(5):1668–74.

    Article  CAS  PubMed  Google Scholar 

  26. Dodson SF, Bonham CA, Geller DA, Cacciarelli TV, Rakela J, Fung JJ. Prevention of de novo hepatitis B infection in recipients of hepatic allografts from anti-HBc positive donors. Transplantation. 1999;68(7):1058–61.

    Article  CAS  PubMed  Google Scholar 

  27. Markowitz JS, Martin P, Conrad AJ, Markmann JF, Seu P, Yersiz H, et al. Prophylaxis against hepatitis B recurrence following liver transplantation using combination lamivudine and hepatitis B immune globulin. Hepatology. 1998;28(2):585–9. doi:10.1002/hep.510280241.

    Article  CAS  PubMed  Google Scholar 

  28. Wachs ME, Amend WJ, Ascher NL, Bretan PN, Emond J, Lake JR, et al. The risk of transmission of hepatitis B from HBsAg (−), HBcAb (+), HBIgM (−) organ donors. Transplantation. 1995;59(2):230–4.

    Article  CAS  PubMed  Google Scholar 

  29. Dodson SF, Issa S, Araya V, Gayowski T, Pinna A, Eghtesad B, et al. Infectivity of hepatic allografts with antibodies to hepatitis B virus. Transplantation. 1997;64(11):1582–4.

    Article  CAS  PubMed  Google Scholar 

  30. Taylor RM, Pietroski RE, Hagan M, Eisenbrey AB, Fontana RJ. Seropositive abdominal and thoracic donor organs are largely underutilized. Transplant Proc. 2010;42(10):4479–87. doi:10.1016/j.transproceed.2010.10.011.

    Article  CAS  PubMed  Google Scholar 

  31. Nery JR, Nery-Avila C, Reddy KR, Cirocco R, Weppler D, Levi DM, et al. Use of liver grafts from donors positive for antihepatitis B-core antibody (anti-HBc) in the era of prophylaxis with hepatitis-B immunoglobulin and lamivudine. Transplantation. 2003;75(8):1179–86. doi:10.1097/01.tp.0000065283.98275.fe.

    Article  CAS  PubMed  Google Scholar 

  32. •• Angelico M, Nardi A, Marianelli T, Caccamo L, Romagnoli R, Tisone G et al. Hepatitis B-core antibody positive donors in liver transplantation and their impact on graft survival: evidence from the Liver Match cohort study. J Hepatol. 2013;58(4):715–23. doi:10.1016/j.jhep.2012.11.025. Recent report describing the use of Hepatitis B-core donors in liver transplant.

  33. Manzarbeitia C, Reich DJ, Ortiz JA, Rothstein KD, Araya VR, Munoz SJ. Safe use of livers from donors with positive hepatitis B core antibody. Liver Transplant. 2002;8(6):556–61. doi:10.1053/jlts.2002.33451.

    Article  Google Scholar 

  34. Perrillo RP, Eason JD. The use of HBsAg-positive organ donors: far more than meets the eye? Liver Transplant. 2005;11(8):875–7. doi:10.1002/lt.20449.

    Article  Google Scholar 

  35. Franchello A, Ghisetti V, Marzano A, Romagnoli R, Salizzoni M. Transplantation of hepatitis B surface antigen-positive livers into hepatitis B virus-positive recipients and the role of hepatitis delta coinfection. Liver Transplant. 2005;11(8):922–8. doi:10.1002/lt.20471.

    Article  Google Scholar 

  36. Choi Y, Choi JY, Yi NJ, Lee K, Mori S, Hong G, et al. Liver transplantation for HBsAg-positive recipients using grafts from HBsAg-positive deceased donors. Transplant Int. 2013;26(12):1173–83. doi:10.1111/tri.12177.

    Article  CAS  Google Scholar 

  37. Loggi E, Micco L, Ercolani G, Cucchetti A, Bihl FK, Grazi GL, et al. Liver transplantation from hepatitis B surface antigen positive donors: a safe way to expand the donor pool. J Hepatol. 2012;56(3):579–85. doi:10.1016/j.jhep.2011.09.016.

    Article  PubMed  Google Scholar 

  38. Jiang L, Yan L, Li B, Wen T, Zhao J, Jiang L, et al. Successful use of hepatitis B surface antigen-positive liver grafts in recipients with hepatitis B virus-related liver diseases. Liver Transplant. 2011;17(10):1236–8. doi:10.1002/lt.22379.

    Article  Google Scholar 

  39. Fox AN, Vagefi PA, Stock PG. Liver transplantation in HIV patients. Semin Liver Dis. 2012;32(2):177–85. doi:10.1055/s-0032-1316474.

    Article  CAS  PubMed  Google Scholar 

  40. Boyarsky BJ, Hall EC, Singer AL, Montgomery RA, Gebo KA, Segev DL. Estimating the potential pool of HIV-infected deceased organ donors in the United States. Am J Transplant. 2011;11(6):1209–17. doi:10.1111/j.1600-6143.2011.03506.x.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Cassuto JR, Patel SA, Tsoulfas G, Orloff MS, Abt PL. The cumulative effects of cold ischemic time and older donor age on liver graft survival. J Surg Res. 2008;148(1):38–44. doi:10.1016/j.jss.2008.03.018.

    Article  PubMed  Google Scholar 

  42. Reese PP, Sonawane SB, Thomasson A, Yeh H, Markmann JF. Donor age and cold ischemia interact to produce inferior 90-day liver allograft survival. Transplantation. 2008;85(12):1737–44. doi:10.1097/TP.0b013e3181722f75.

    Article  CAS  PubMed  Google Scholar 

  43. Lake JR, Shorr JS, Steffen BJ, Chu AH, Gordon RD, Wiesner RH. Differential effects of donor age in liver transplant recipients infected with hepatitis B, hepatitis C and without viral hepatitis. Am J Transplant. 2005;5(3):549–57. doi:10.1111/j.1600-6143.2005.00741.x.

    Article  PubMed  Google Scholar 

  44. Russo MW, Galanko JA, Zacks SL, Beavers KL, Fried MW, Shrestha R. Impact of donor age and year of transplant on graft survival in liver transplant recipients with chronic hepatitis C. Am J Transplant. 2004;4(7):1133–8. doi:10.1111/j.1600-6143.2004.00470.x.

    Article  PubMed  Google Scholar 

  45. Pascher A, Gerlach U, Neuhaus P. Bile duct strictures after liver transplantation. Curr Opin Gastroenterol. 2014;30(3):320–5. doi:10.1097/MOG.0000000000000061.

    Article  PubMed  Google Scholar 

  46. (SRTR) SRoTR. Reported deaths and annual death rate per 1000 patient/years at risk/liver waiting list. 2011.

  47. Anderson CD, Vachharajani N, Doyle M, Lowell JA, Wellen JR, Shenoy S, et al. Advanced donor age alone does not affect patient or graft survival after liver transplantation. J Am Coll Surg. 2008;207(6):847–52. doi:10.1016/j.jamcollsurg.2008.08.009.

    Article  PubMed  Google Scholar 

  48. Jimenez-Romero C, Clemares-Lama M, Manrique-Municio A, Garcia-Sesma A, Calvo-Pulido J, Moreno-Gonzalez E. Long-term results using old liver grafts for transplantation: sexagenerian versus liver donors older than 70 years. World J Surg. 2013;37(9):2211–21. doi:10.1007/s00268-013-2085-7.

    Article  PubMed  Google Scholar 

  49. Kim DY, Moon J, Island ER, Tekin A, Ganz S, Levi D, et al. Liver transplantation using elderly donors: a risk factor analysis. Clin Transplant. 2011;25(2):270–6. doi:10.1111/j.1399-0012.2010.01222.x.

    Article  PubMed  Google Scholar 

  50. Ono Y, Kawachi S, Hayashida T, Wakui M, Tanabe M, Itano O, et al. The influence of donor age on liver regeneration and hepatic progenitor cell populations. Surgery. 2011;150(2):154–61. doi:10.1016/j.surg.2011.05.004.

    Article  PubMed  Google Scholar 

  51. Segev DL, Maley WR, Simpkins CE, Locke JE, Nguyen GC, Montgomery RA, et al. Minimizing risk associated with elderly liver donors by matching to preferred recipients. Hepatology. 2007;46(6):1907–18. doi:10.1002/hep.21888.

    Article  PubMed  Google Scholar 

  52. Cameron AM, Ghobrial RM, Yersiz H, Farmer DG, Lipshutz GS, Gordon SA, et al. Optimal utilization of donor grafts with extended criteria: a single-center experience in over 1000 liver transplants. Ann Surg. 2006;243(6):748–53. doi:10.1097/01.sla.0000219669.84192.b3 discussion 53–5.

    Article  PubMed Central  PubMed  Google Scholar 

  53. •• Paterno F, Wima K, Hoehn RS, Cuffy MC, Diwan TS, Woodle SE, Abbott DE, Shah SA. Use of elderly allografts in liver transplantation. Transplantation. 2015. doi:10.1097/TP.0000000000000806. Multi-center database study showing effective use of older donor allografts.

  54. •• Salvalaggio PR, Dzebisashvili N, MacLeod KE, Lentine KL, Gheorghian A, Schnitzler MA, et al. The interaction among donor characteristics, severity of liver disease, and the cost of liver transplantation. Liver Transplant. 2011;17(3):233–42. doi:10.1002/lt.22230. First study documenting interaction between DRI, MELD and cost.

  55. Mutimer DJ, Gunson B, Chen J, Berenguer J, Neuhaus P, Castaing D, et al. Impact of donor age and year of transplantation on graft and patient survival following liver transplantation for hepatitis C virus. Transplantation. 2006;81(1):7–14.

    Article  PubMed  Google Scholar 

  56. Imber CJ, St Peter SD, Lopez I, Guiver L, Friend PJ. Current practice regarding the use of fatty livers: a trans-Atlantic survey. Liver Transplant. 2002;8(6):545–9. doi:10.1053/jlts.2002.31747.

    Article  Google Scholar 

  57. Nickkholgh A, Weitz J, Encke J, Sauer P, Mehrabi A, Buchler MW, et al. Utilization of extended donor criteria in liver transplantation: a comprehensive review of the literature. Nephrol Dial Transplant. 2007;22(Suppl 8):viii29–36. doi:10.1093/ndt/gfm654.

    PubMed  Google Scholar 

  58. Cucchetti A, Vivarelli M, Ravaioli M, Cescon M, Ercolani G, Piscaglia F, et al. Assessment of donor steatosis in liver transplantation: is it possible without liver biopsy? Clin Transplant. 2009;23(4):519–24. doi:10.1111/j.1399-0012.2009.00987.x.

    Article  PubMed  Google Scholar 

  59. Spitzer AL, Lao OB, Dick AA, Bakthavatsalam R, Halldorson JB, Yeh MM, et al. The biopsied donor liver: incorporating macrosteatosis into high-risk donor assessment. Liver Transplant. 2010;16(7):874–84. doi:10.1002/lt.22085.

    Article  Google Scholar 

  60. Perito ER, Rhee S, Glidden D, Roberts JP, Rosenthal P. Impact of the donor body mass index on the survival of pediatric liver transplant recipients and post-transplant obesity. Liver Transplant. 2012;18(8):930–9. doi:10.1002/lt.23438.

    Article  Google Scholar 

  61. de Graaf EL, Kench J, Dilworth P, Shackel NA, Strasser SI, Joseph D, et al. Grade of deceased donor liver macrovesicular steatosis impacts graft and recipient outcomes more than the Donor Risk Index. J Gastroenterol Hepatol. 2012;27(3):540–6. doi:10.1111/j.1440-1746.2011.06844.x.

    Article  PubMed  Google Scholar 

  62. Cieslak B, Lewandowski Z, Urban M, Ziarkiewicz-Wroblewska B, Krawczyk M. Microvesicular liver graft steatosis as a risk factor of initial poor function in relation to suboptimal donor parameters. Transplant Proc. 2009;41(8):2985–8. doi:10.1016/j.transproceed.2009.08.019.

    Article  CAS  PubMed  Google Scholar 

  63. •• Orman ES, Mayorga ME, Wheeler SB, Townsley RM, Toro-Diaz HH, Hayashi PH et al. Declining liver graft quality threatens the future of liver transplantation in the United States. Liver Transpl 2015. doi:10.1002/lt.24160. Future of donor organs appears to be in decline and this could jeopardize liver tranplant utility and outcomes.

  64. •• Singhal A, Wilson GC, Wima K, Quillin RC, Cuffy M, Anwar N et al. Impact of recipient morbid obesity on outcomes after liver transplantation. Transpl Int. 2015;28(2):148–55. doi:10.1111/tri.12483. Obese recipient outcome after OLT in multi-center cohort study.

  65. McCormack L, Petrowsky H, Jochum W, Mullhaupt B, Weber M, Clavien PA. Use of severely steatotic grafts in liver transplantation: a matched case-control study. Ann Surg. 2007;246(6):940–6. doi:10.1097/SLA.0b013e31815c2a3f discussion 6–8.

    Article  PubMed  Google Scholar 

  66. Deroose JP, Kazemier G, Zondervan P, Ijzermans JN, Metselaar HJ, Alwayn IP. Hepatic steatosis is not always a contraindication for cadaveric liver transplantation. HPB. 2011;13(6):417–25. doi:10.1111/j.1477-2574.2011.00310.x.

    Article  PubMed Central  PubMed  Google Scholar 

  67. Goldaracena N, Quinonez E, Mendez P, Anders M, Orozco Ganem F, Mastai R, et al. Extremely marginal liver grafts from deceased donors have outcome similar to ideal grafts. Transplant Proc. 2012;44(7):2219–22. doi:10.1016/j.transproceed.2012.07.113.

    Article  CAS  PubMed  Google Scholar 

  68. Avolio AW, Frongillo F, Nicolotti N, Mule A, Vennarecci G, De Simone P, et al. Successful use of extended criteria donor grafts with low to moderate steatosis in patients with model for end-stage liver disease scores below 27. Transplant Proc. 2009;41(1):208–12. doi:10.1016/j.transproceed.2008.10.050.

    Article  CAS  PubMed  Google Scholar 

  69. • Dutkowski P, Schlegel A, Slankamenac K, Oberkofler CE, Adam R, Burroughs AK et al. The use of fatty liver grafts in modern allocation systems: risk assessment by the balance of risk (BAR) score. Ann Surg. 2012;256(5):861–8; discussion 8–9. doi:10.1097/SLA.0b013e318272dea2. Important study examining use of fatty grafts and risk assessment.

  70. Buell JF, Beebe TM, Trofe J, Gross TG, Alloway RR, Hanaway MJ, et al. Donor transmitted malignancies. Ann Transplant. 2004;9(1):53–6.

    PubMed  Google Scholar 

  71. Desai R, Collett D, Watson CJ, Johnson P, Evans T, Neuberger J. Cancer transmission from organ donors-unavoidable but low risk. Transplantation. 2012;94(12):1200–7. doi:10.1097/TP.0b013e318272df41.

    Article  PubMed  Google Scholar 

  72. Buell JF, Hanaway MJ, Thomas M, Munda R, Alloway RR, First MR, et al. Donor kidneys with small renal cell cancers: can they be transplanted? Transplant Proc. 2005;37(2):581–2. doi:10.1016/j.transproceed.2004.12.118.

    Article  CAS  PubMed  Google Scholar 

  73. Nalesnik MA, Woodle ES, Dimaio JM, Vasudev B, Teperman LW, Covington S, et al. Donor-transmitted malignancies in organ transplantation: assessment of clinical risk. Am J Transplant. 2011;11(6):1140–7. doi:10.1111/j.1600-6143.2011.03565.x.

    Article  CAS  PubMed  Google Scholar 

  74. Kim B, Woreta T, Chen PH, Limketkai B, Singer A, Dagher N, et al. Donor-transmitted malignancy in a liver transplant recipient: a case report and review of literature. Dig Dis Sci. 2013;58(5):1185–90. doi:10.1007/s10620-012-2501-0.

    Article  PubMed  Google Scholar 

  75. Zelinkova Z, Geurts-Giele I, Verheij J, Metselaar H, Dinjens W, Dubbink HJ, et al. Donor-transmitted metastasis of colorectal carcinoma in a transplanted liver. Transplant international : official journal of the European Society for Organ Transplantation. 2012;25(1):e10–5. doi:10.1111/j.1432-2277.2011.01380.x.

    Article  Google Scholar 

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Correspondence to Shimul A. Shah.

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Diwan, T.S., Paterno, F. & Shah, S.A. Use of Extended Criteria Deceased Donors in Adult Liver Transplantation. Curr Surg Rep 3, 25 (2015). https://doi.org/10.1007/s40137-015-0103-4

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