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MATERIALS AND METHODS

A liver graft offer from a 29‐year‐old male DCD donor was initially accepted for transplantation by our center within the same allocation region. Withdrawal of life support was performed in accordance with the UK standard practice, in the intensive care unit, without administration of heparin before withdrawal. Oxygen saturation fell quickly and was not measureable within minutes of treatment withdrawal, heralding the onset of donor warm ischemia. However, cardiac death did not occur until 1 hour and 49 minutes later, and this exceeded the current UK recommended criteria of liver graft use from donors with warm ischemia time of< 30 minutes. Standard organ procurement followed, however, using University of Wisconsin perfusion solution containing heparin. The procuring surgeon described the graft as a nonsteatotic liver, with soft consistency and several areas of suboptimal perfusion.