Donor warm ischemia (dWIT) has implications on outcomes following liver transplantation (LT) in organs from donors after cardiac death (DCD). Pre-hospital cardiac arrest (PHCA) prior to donation may generate a further ischemic insult. The aim of this single-center study of 108 consecutive DCD LT is to compare the outcomes of both PHCA and non-PHCA cohorts. A review of a prospectively collected database of all DCD grafts transplanted between January 2007 and October 2011 was undertaken to identify donors who sustained PHCA. The Unit policy was to consider such donors when transaminases were < 4 times normal range and with an improving trend. Of 108 DCD transplants, 26 were from DCD donors with PHCA and 82 were in the non-PHCA cohort. A comparative analysis between PHCA and non-PHCA cohorts showed a better short-term (low incidence of Acute Kidney Injury-AKI) in favor of the PHCA group and a satisfactory long-term results showing no significant difference in graft or patient survival between the two groups. A careful donor selection policy to include PHCA DCD with normalized liver function tests or <4 times normal has resulted in successful transplantation that could boost the donor pool with no adverse outcomes. Liver Transpl , 2013. © 2013 AASLD.