The goal of this observational study is to describe the details of a controlled administration strategy of cold preservation solution or oxygenated cold preservation solution at the end of Abdominal Normothermic Regional Perfusion (A-NRP) in Controlled Donation afeter Circulatory determination of Death (cDCD) III donors.

The main purpose is to:

develope a standardized protocol for this type of donor

Data collected from partecipants, deceased donors belonging to cDCD III category, willl be analysed through descriptive stastistics.

Inclusion Criteria:

• Deceased donor screened for death according to category III cardiovascular criteria, according to the modified Maastricht classification, procured and subjected to Abdominal Normothermic Regional Perfusion (A-NRP);
• Donor risk assessment as standard or negligible/acceptable non-standard risk, according to the nomenclature and guidelines of the National Transplant Center (risk definition is established by the CRT-ER, possibly after consulting with the national second opinion)

Exclusion Criteria:

• Presence of absolute contraindications to organ donation;
• Dissent to donation expressed during life;
• Opposition by eligible family members unless specifically expressing their wishes;
• Unacceptable risk according to the National Transplant Center (CNT) guidelines;
• Lack of authorization from the Prosecutor's Office in cases where required;
• Infeasibility of the controlled administration of cold preservation solution with or without oxygenation, in the judgment of the first operator and/or the perfusionist in charge.

Donors belonging to the cDCD III category who have undergone A-NRP and liver or liver and kidney procurement for transplantation at one of the participating centers during the study period will be enrolled. At least one liver will subsequently be transplanted at the coordinating center. The study design includes two cohorts, one retrospective and one prospective. The retrospective cohort will include 10 donors belonging to the cDCD III category, whose organs were procured between January 2024 and December 2024. The prospective cohort will include all cDCD III donors who have undergone A-NRP and liver or liver and kidney procurement for transplantation at one of the participating centers from 01/01/2025 onwards and are eligible for the study, up to a number of 10 cases (20 cases overall).

The investigator undertakes to make the study protocol and results public. To this end, the study will be registered on an Open Science platform. Any formal presentation or publication of data derived from this study should be considered a publication by the investigator.

The data will be made available in anonymized form upon a reasoned request to the study's PI.