*Purpose: With the shortage of organs for liver transplantation (LT), different solutions have been proposed to expand the donor pool: utilization of extended criteria organs, living donation, machine perfusion and donation after circulatory death (DCD) organs. The aim of this study is to evaluate the trend of DCD liver graft utilization in the last decade in the U.S. and determine the impact of increased DCD LT if all centers utilize these organs.

*Methods: Using the OPTN database, we collected the annual total LT and DCD volume and calculated the % of total LT volume comprised of DCD LT for active adult transplant centers in U.S. between January 1, 2010 and December 31, 2020.

*Results: In 2010, 32 and 13 transplant centers did 5% or 10% DCD donors, respectively. In 2020, the centers that used 5% or 10% of DCD donors increased to 57 and 34 centers, respectively. In 2020, 45, 27 and 12 centers did more than 5, 10 or 20 DCD LT/year, respectively. Based on the 2020 data, if all active adult LT programs do at least 5 or 10 DCD LT/year, we would increase LT by 278 or 694 LT/per year.

*Conclusions: We found that there has been an increase in the number of LT programs utilizing DCDs as well as the volumes of programs that utilize DCDs. The theoretical impact of the wider adoption of DCD LT would substantially increase the volume of LT in the US.

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