*Purpose: DCD are a key way to expand the donor pool, yet many centers are hesitant about using anything but the most favorable DCD allografts, given the lack of data regarding older donors. Expanding to older DCD donors >50 years may be an untapped potential option to increase donor liver supply.

*Methods: All primary liver-only DCD from 2010 – 2021 were compiled in a prospective database, analyzing outcomes. Donor and logistical parameters, recipient surgical parameters, and transplant outcomes were assessed, stratifying by donor age groups.

*Results: n= 139 of 173 DCD livers performed met inclusion criteria.

n= 19 DCD >50yrs had effective WIT of 19.3min and incision time of 3.0min, similar to other age stratifications, traveling similar distances with a similar percentage requiring flights.

Recipients of >50yr DCD had similar surgical parameters but lower mean MELD score 21.4.

The >50 yr donor group had a 1-yr patient and graft survival of 100% and 94.7% with no episodes of ischemic cholangiopathy and a hospital LOS of 5d.

*Conclusions: >50 year old DCD livers can be transplanted with excellent patient and graft survival, low ischemic cholangiopathy and short hospital stays, with results similar to younger DCD donors. The MELD score of this group was significantly lower than other age groups by intention and thus consideration can be given to pursue these >50 year old DCD livers, even at flight distances, if they can be transplanted into low MELD recipients.

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