1. Background The renewed interest in DCD started since the 1990s following the persistent organ shortage from donation after brain death (DBD) and the short- and mid-term encouraging results of kidney, liver, pancreas and lung transplantation from DCD. ‘Donor-type redistribution or substitution within the deceased donor (DD) pool’ was promptly recognized along with its potentially harmful effects on DBD activity. Our aim is to report the controlled DCD experience at the University Hospital of Liège, Belgium, from 2002 through 2012, in a donor region of about 1 million habitants, in order to assess the impact of DCD activity on our transplant activity, and to exclude any decrease in DBD as a consequence of DCD programs. Material Methods Data related to donation and transplantation activities were prospectively collected for retrospective retrieval and comparison with the annual reports of Eurotransplant organization and Belgian Section of Transplant Coordinators. Data involving donation activity: number of referred and effective donors, conversion rate, percentage of donation refusal, reasons for denial of donation, and organ yield. Donor profile: age, gender, Maastricht category, donor origin, cause of donor death, time from ventilator switch-off to cardiac arrest, time from cardiac arrest to aortic cold perfusion, and total warm ischemia time (WIT). DONATION AFTER CARDIAC DEATH (DCD) INCREASES THE CADAVERIC DONOR POOL Le Dinh H, Detry O, de Roover A, Honoré P, Joris J, Ledoux D, Squifflet JP, Meurisse M University Hospital of Liège, University of Liège, Belgium

2. Results Donor characteristicsMean/PercentageRange Age (years)54.6 ± 15.83 - 83 Age category (%) <40 years 40-59 years ≥60 years 15.1 40.8 44.1 Gender (male / female, %)74.2 / 25.8 Donor category (%) Maastricht category III Maastricht category V 100 0 Donor characteristicsMean/PercentageRange Cause of death (%) Cranial trauma Cerebral vascular accident Anoxia Suicide Other causes 16.1 26.9 47.3 7.5 2.2 Agonal time (min)10.6 ± 6.41 - 30 Asystolic time (min)8.9 ± 2.43 - 16 Total WIT (min)19.5 ± 6.86 - 39 54

3. Results Discussion DCD donors enlarged the total DD pool without compromising the development of an existing DBD program. In Liège region: only 37% of the potential DCD donors were referred for organ donation in comparison to 67.2% of the DBD counterparts. Among various reasons of non-referral, the lack of awareness of the DCD donor suitability for transplantation was attributed to 37% of cases. Therefore, the potential DCD pool is still underused and appears as a valuable donor source for transplantation.