{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:34:18Z","timestamp":1790660058512,"version":"4.1.0"},"reference-count":63,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":639,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Organs from donors after circulatory death (DCDs) are particularly susceptible to the effects of warm ischemia injury. Regional perfusion (RP) by extracorporeal membrane oxygenation (ECMO) is increasingly being advocated as a useful remedy to the effects of ischemia\/reperfusion injury, and it has been reported to enable the transplantation of organs from donors previously deemed unsuitable. The MEDLINE, Embase, and Cochrane databases were searched, and articles published between 1997 and 2013 were obtained. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two hundred ten articles were identified, and 11 were eligible for inclusion. Four hundred eighty-two kidneys and 79 livers were transplanted from regional perfusion\u2013supported donor after circulatory death (RP-DCD) sources. One-year graft survival was lower with uncontrolled RP-DCD liver transplantation, whereas 1-year patient survival was similar. Primary nonfunction and ischemic cholangiopathy were significantly more frequent with RP-DCDs versus donors after brain death (DBDs), but there was no difference in postoperative mortality between the 2 groups. The 1-year patient and graft survival rates for RP-DCD kidney transplantation were better than the rates with standard DCDs and were comparable to, if not better than, the rates with DBDs. At experienced centers, delayed graft function (DGF) for kidney transplantation from RP-DCDs was much less frequent in comparison with all other donor types. In conclusion, RP aids the recovery of DCD organs from ischemic injury and enables transplantation with acceptable survival. RP may help to increase the donor pool, but its benefits must still be balanced with the recognition of significantly higher rates of complications in liver transplantation. In kidney transplantation, significant reductions in DGF can be obtained with RP, and there are potentially important implications for long-term outcomes. Significant ethicolegal issues exist, and they are preventing a worldwide consensus on optimum RP protocols and an accurate appreciation of outcomes. <jats:italic toggle=\"yes\">Liver Transpl 19:1292-1303, 2013<\/jats:italic>. \u00a9 2013 AASLD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.23771","type":"journal-article","created":{"date-parts":[[2013,10,17]],"date-time":"2013-10-17T19:53:09Z","timestamp":1382039589000},"page":"1292-1303","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":51,"title":["Regional perfusion by extracorporeal membrane oxygenation of abdominal organs from donors after circulatory death: A systematic review"],"prefix":"10.1097","volume":"19","author":[{"given":"Iestyn M.","family":"Shapey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Muiesan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R5-3-20250124","doi-asserted-by":"crossref","first-page":"627633","DOI":"10.1111\/j.1399-0012.2004.00287.x","article-title":"A report on the activity and clinical outcomes of renal nonheart beating donor transplantation in the United Kingdom.","volume":"18","author":"Brook","year":"2004","journal-title":"Clin Transplant"},{"key":"R6-3-20250124","doi-asserted-by":"crossref","first-page":"685691","DOI":"10.1002\/bjs.6607","article-title":"Casematched comparison of longterm results of nonheart beating and heartbeating donor renal transplants.","volume":"96","author":"Barlow","year":"2009","journal-title":"Br J Surg"},{"key":"R7-3-20250124","doi-asserted-by":"crossref","first-page":"732738","DOI":"10.1097\/01.sla.0000186177.26112.d2","article-title":"Singlecenter experience with liver transplantation from controlled nonheartbeating donors: a viable source of grafts.","volume":"242","author":"Muiesan","year":"2005","journal-title":"Ann Surg"},{"key":"R8-3-20250124","doi-asserted-by":"crossref","first-page":"744753","DOI":"10.1002\/bjs.7043","article-title":"Similar liver transplantation survival with selected cardiac death donors and brain death donors.","volume":"97","author":"Dubbeld","year":"2010","journal-title":"Br J Surg"},{"key":"R9-3-20250124","doi-asserted-by":"crossref","first-page":"692702","DOI":"10.1016\/j.surg.2011.07.057","article-title":"Donation after cardiac death: a 29year experience.","volume":"150","author":"Bellingham","year":"2011","journal-title":"Surgery"},{"key":"R10-3-20250124","first-page":"28932894","article-title":"Categories of nonheartbeating donors.","volume":"27","author":"Kootstra","year":"1995","journal-title":"Transplant Proc"},{"key":"R11-3-20250124","first-page":"350358","article-title":"Renal transplantation from nonheart beating donors: a promising alternative to enlarge the donor pool.","volume":"11","author":"SanchezFructuoso","year":"2000","journal-title":"J Am Soc Nephrol"},{"key":"R12-3-20250124","doi-asserted-by":"crossref","first-page":"18491855","DOI":"10.1111\/j.1600-6143.2007.01846.x","article-title":"Liver transplant using donors after unexpected cardiac death: novel preservation protocol and acceptance criteria.","volume":"7","author":"Fondevila","year":"2007","journal-title":"Am J Transplant"},{"key":"R13-3-20250124","doi-asserted-by":"crossref","first-page":"609616","DOI":"10.1046\/j.1365-2168.2002.02052.x","article-title":"Extended preservation of nonheartbeating donor livers with normothermic machine perfusion.","volume":"89","author":"St Peter","year":"2002","journal-title":"Br J Surg"},{"key":"R14-3-20250124","doi-asserted-by":"crossref","first-page":"8693","DOI":"10.1016\/S0014-4800(03)00008-X","article-title":"Hepatic ischemiareperfusion injurya fresh look.","volume":"74","author":"Fondevila","year":"2003","journal-title":"Exp Mol Pathol"},{"key":"R15-3-20250124","doi-asserted-by":"crossref","first-page":"445451","DOI":"10.1097\/TP.0b013e31817fe0cd","article-title":"The effect of warm ischemic time on renal function and injury in the isolated hemoperfused kidney.","volume":"86","author":"Harper","year":"2008","journal-title":"Transplantation"},{"key":"R16-3-20250124","doi-asserted-by":"crossref","first-page":"123127","DOI":"10.1097\/00007890-198901000-00027","article-title":"Cardiopulmonary bypass with profound hypothermia. An optimal preservation method for multiorgan procurement.","volume":"47","author":"Baumgartner","year":"1989","journal-title":"Transplantation"},{"key":"R17-3-20250124","doi-asserted-by":"crossref","first-page":"21912194","DOI":"10.1016\/j.athoracsur.2007.01.033","article-title":"First human transplantation of a nonacceptable donor lung after reconditioning ex vivo.","volume":"83","author":"Steen","year":"2007","journal-title":"Ann Thorac Surg"},{"key":"R18-3-20250124","doi-asserted-by":"crossref","first-page":"162165","DOI":"10.1510\/icvts.2010.244830","article-title":"Comparative outcome of double lung transplantation using conventional donor lungs and nonacceptable donor lungs reconditioned ex vivo.","volume":"12","author":"Lindstedt","year":"2011","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"R19-3-20250124","doi-asserted-by":"crossref","first-page":"372381","DOI":"10.1111\/j.1600-6143.2009.02932.x","article-title":"Hypothermic machine preservation in human liver 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