Background Liver transplantation is the definitive therapy for end‐stage liver disease. The severe organ shortage necessitates exploring grafts from extended‐criteria donors, including those who become brain dead due to toxicological causes. This study evaluated the outcomes of liver transplantation using grafts from brain‐dead donors with confirmed warfarin‐associated coagulopathy (WAC). Methods This retrospective observational cohort study was conducted at a high‐volume transplant center (1994–2024). Ten recipients who received liver grafts from brain‐dead donors with WAC were included. Clinical data were reviewed to assess liver function recovery, complications, and survival. Results The cohort included 10 recipients (8 males, 2 females; mean age: 49.8 ± 13.2 years). Liver function tests and international normalized ratio (INR) levels showed significant improvement by Postoperative day 7. Acute rejection occurred in two recipients (20%), successfully treated with corticosteroids. One patient (10%) developed primary nonfunction, leading to death. Patient survival was 100% at 30 days and 70% at 1 year; corresponding graft survival was 90% and 70%. Conclusion In this small, highly selected cohort, liver grafts from brain‐dead donors with WAC may be used with acceptable short‐term safety. These preliminary findings demonstrate feasibility and highlight the need for larger, controlled studies to further evaluate outcomes and donor selection criteria.
Majd et al. (2026) studied this question.