*Purpose: DCD livers were more prone for ischemic cholangiopathy and graft failure than DBD livers due to multi factorial reasons. With all the available data most centers follow strict criteria in selecting the DCD livers. In spite of following specific criteria some DCD livers fail to end up in re transplant or sometimes death.Aim:To analyze the data and find the reasons that why some DCD livers fail and end up in re transplant in spite of following our center specific strict criteria in selecting in the DCD liver donors.

*Methods: Retrospective analysis of the DCD liver recipients who required re transplant from Jan 2008 to December 2020 were done. All-important parameters like functional WIT, donor age, CIT, recipient MELD, donor and recipient TPA injection, intra operative blood loss and transfusions, re exploration and post DCD liver explant biopsy after re transplantation were studied.

*Results: Total DCD transplants undergone during this period was 147. Out of which 11 re transplants were done. 3 DCD livers failed due to PNF, 2 failed due to ischemic cholangiopathy, 4 failed due to bile duct anastomotic stricture ending up in secondary biliary cirrhosis and 2 patients had chronic rejection. All these patients had more than 5 hours of cold ischemic time(CIT), less than 30 mins WIT except one patient had 33 mins. 5 out 11 patients had immediate re exploration for bleeding and hypotension. 2 patients re exploration done for post op bile leak. 3 of the donors had infective episode which was optimized before procurement.

*Conclusions: The study concluded that CIT of more than 5 hours and patients who needed immediate post op re exploration were the significant reasons for these DCD liver grafts failure in spite of following strict criteria in selecting the DCD livers. Hence DCD liver transplants should go uneventful normal course because they will not tolerate further adverse events.

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