Efforts have been made by the transplant community to expand the deceased donor pool in paediatric liver transplantation (LT).\nThe growing experience on donation after circulatory death (DCD) for adult LT has encouraged its use also in children, albeit in\nselective cases, opening newperspectives for paediatric patients. Even though there has recently been a slight increase in the number\nof DCD livers transplanted in children, with satisfactory graft and patient outcomes, the use of DCD grafts in paediatric recipients\nis still controversial due to morbid outcomes associated with DCD grafts. In this context, recent advances in the optimization\nof donor support by extracorporeal membrane oxygenation and in the graft preservation by liver machine perfusion could find\napplication in order to expand the donor pool in paediatric LT. In the present study we review the current literature on DCD liver\ngrafts transplanted in children and on the use of extracorporeal donor support and liver perfusion machines in paediatrics, with\nthe aim of defining the current status and future perspectives of paediatric LT.
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