Original Articles: Peritransplant and Posttransplant Management and OutcomesLiver transplantation with donation after medical assistance in dying: Case series and systematic review of the literatureGlinka, Juan1; Sachar, Yashasavi2; Tang, Ephraim1; Brahmania, Mayur2,3; Hwang, Jaehyun1; Waugh, Evelyn1; Schmerk, Crystal2; Iansavitchene, Alla4; Quan, Douglas1; Skaro, Anton1 Author Information 1Department of Surgery, London, Ontario, Canada 2Division of Gastroenterology, Department of Medicine; London, Ontario, Canada 3Centre for Quality Improvement, Innovation, and Safety, London, Ontario, Canada 4Library Services, London Health Sciences Centre, Western University; London, Canada Abbreviations: ALP, Alkaline phosphatase; ALT, Alanine transaminase; AST, Aspartate transaminase; CIT, cold ischemic time; DBD, donation after brain death; DCD, donor after circulatory death; DCD-III, standard donor after circulatory death; DCD-V, MAiD & euthanasia donor after circulatory death; EAD, early allograft dysfunction; ERCP, endoscopic retrograde cholangiopancreatography; HAT, hepatic artery thrombosis; IC, ischemic cholangiopathy; INR, international normalized ratio; LHSC, London Health Sciences Centre; LT, liver transplantation; MAiD, medical assistance in dying; MELD, model for end-stage liver disease; N/S, non-specified; NDD, neurodegenerative disorder; PNF, primary nonfunction; UH, University Hospital; WIT, warm ischemic time; WLS, withdrawal of life support. Juan Glinka and Yashasavi Sachar are joint first coauthors. Correspondence Juan Glinka, University Hospital, London Health Sciences Centre Room C4-216, 339 Windermere Road, London, Ontario, Canada, N6A 5A5. Email: [email protected] Earn MOC for this article: https://cme.lww.com/browse/sources/224 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website, www.ltxjournal.com Liver Transplantation 29(6):p 618-625, June 2023. | DOI: 10.1097/LVT.0000000000000100 Buy SDC CME Test Metrics Abstract Medical assistance in dying (MAiD) has been a legally approved practice in Canada since 2016. Only recently have patients undergoing MAiD also been considered as donors for liver transplantation (LT). This study aimed to evaluate a case series of LT outcomes for recipients with MAiD donors and was paired with a systematic literature review of studies assessing the efficacy of MAiD-associated liver donation. A retrospective chart review of patients registered within the LT Registry at London Health Sciences Centre (LHSC) in London, Ontario, Canada, that had received MAiD donor LT was conducted to develop a case series. Descriptive statistics were produced based on available patient outcomes information. The systematic review included euthanasia due to MAiD being a term exclusive to Canada. Case series had a 100% 1-year graft survival rate, with 50% of patients experiencing early allograft dysfunction but having no significant clinical outcome. A single case of postoperative biliary complication was reported. Median warm ischemic time ranged from 7.8–13 minutes among case series and literature reviews. Utilization of donation after circulatory death allografts procured after MAiD appears to be promising. Mechanisms associated with potential impact in postoperative outcomes include relatively lower warm ischemic time relative to donation after circulatory death Maastricht III graft recipients. Copyright © 2023 American Association for the Study of Liver Diseases.