{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:35:15Z","timestamp":1790660115330,"version":"4.1.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>In situ normothermic regional perfusion (NRP) and ex situ normothermic machine perfusion (NMP) aim to improve the outcomes of liver transplantation (LT) using controlled donation after circulatory death (cDCD). NRP and NMP have not yet been compared directly. In this international observational study, outcomes of LT performed between 2015 and 2019 for organs procured from cDCD donors subjected to NRP or NMP commenced at the donor center were compared using propensity score matching (PSM). Of the 224 cDCD donations in the NRP cohort that proceeded to asystole, 193 livers were procured, resulting in 157 transplants. In the NMP cohort, perfusion was commenced in all 40 cases and resulted in 34 transplants (use rates: 70% vs. 85% [<jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.052], respectively). After PSM, 34 NMP liver recipients were matched with 68 NRP liver recipients. The two cohorts were similar for donor functional warm ischemia time (21\u2009min after NRP vs. 20\u2009min after NMP; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.17), UK\u2013Donation After Circulatory Death risk score (5 vs. 5 points; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.38), and laboratory Model for End\u2010Stage Liver Disease scores (12 vs. 12 points; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.83). The incidence of nonanastomotic biliary strictures (1.5% vs. 2.9%; <jats:italic toggle=\"yes\">p<\/jats:italic>\u2009&gt;\u20090.99), early allograft dysfunction (20.6% vs. 8.8%; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.13), and 30\u2010day graft loss (4.4% vs. 8.8%; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.40) were similar, although peak posttransplant aspartate aminotransferase levels were higher in the NRP cohort (872 vs. 344 IU\/L; <jats:italic toggle=\"yes\">p<\/jats:italic>\u2009&lt;\u20090.001). NRP livers were more frequently allocated to recipients suffering from hepatocellular carcinoma (HCC; 60.3% vs. 20.6%; <jats:italic toggle=\"yes\">p<\/jats:italic>\u2009&lt;\u20090.001). HCC\u2010censored 2\u2010year graft and patient survival rates were 91.5% versus 88.2% (<jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.52) and 97.9% versus 94.1% (<jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.25) after NRP and NMP, respectively. Both perfusion techniques achieved similar outcomes and appeared to match benchmarks expected for donation after brain death livers. This study may inform the design of a definitive trial.<\/jats:p>","DOI":"10.1002\/lt.26522","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T14:59:45Z","timestamp":1654268385000},"page":"1716-1725","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":53,"title":["In situ normothermic regional perfusion versus ex situ normothermic machine perfusion in liver transplantation from donation after circulatory death"],"prefix":"10.1097","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9695-0902","authenticated-orcid":false,"given":"Kayvan","family":"Mohkam","sequence":"first","affiliation":[{"name":"Department of Digestive Surgery & Liver Transplantation, Croix\u2010Rousse Hospital, Hospices Civils de Lyon,Claude Bernard Lyon 1 University,Lyon,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Nasralla","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Liver Transplant Surgery,Royal Free Hospital,London,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5480-9380","authenticated-orcid":false,"given":"Hynek","family":"Mergental","sequence":"additional","affiliation":[{"name":"Liver Unit, Queen Elizabeth Hospital,University Hospitals Birmingham,Birmingham,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8849-5495","authenticated-orcid":false,"given":"Xavier","family":"Muller","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery & Liver Transplantation, Croix\u2010Rousse Hospital, Hospices Civils de Lyon,Claude Bernard Lyon 1 University,Lyon,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Butler","sequence":"additional","affiliation":[{"name":"Department of Surgery, Addenbrooke's Hospital,University of Cambridge,Cambridge,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayel","family":"Jassem","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies,King's College Hospital,London,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Imber","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Liver Transplant Surgery,Royal Free Hospital,London,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diethard","family":"Monbaliu","sequence":"additional","affiliation":[{"name":"Abdominal Transplant Surgery Unit, Department of Surgery,University Hospitals Leuven,Leuven,Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Thamara P. R.","family":"Perera","sequence":"additional","affiliation":[{"name":"Liver Unit, Queen Elizabeth Hospital,University Hospitals Birmingham,Birmingham,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard W.","family":"Laing","sequence":"additional","affiliation":[{"name":"Liver Unit, Queen Elizabeth Hospital,University Hospitals Birmingham,Birmingham,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Garc\u00eda\u2010Valdecasas","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliopancreatic and Transplant Surgery,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery,University Hospital Essen,Essen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Dondero","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliopancreatic Surgery,Department of Hepatopancreatobiliary Surgery and Liver Transplantation,Beaujon Hospital, Assitance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP), University Paris Cit\u00e9,Clichy,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Cauchy","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliopancreatic Surgery,Department of Hepatopancreatobiliary Surgery and Liver Transplantation,Beaujon Hospital, Assitance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP), University Paris Cit\u00e9,Clichy,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4131-2222","authenticated-orcid":false,"given":"Eric","family":"Savier","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery and Liver Transplantation, Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital,Sorbonne University,Paris,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Scatton","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery and Liver Transplantation, Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital,Sorbonne University,Paris,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabien","family":"Robin","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Digestive Surgery,Pontchaillou University Hospital,Rennes,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Sulpice","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Digestive Surgery,Pontchaillou University Hospital,Rennes,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petru","family":"Bucur","sequence":"additional","affiliation":[{"name":"Department of Digestive, Oncological, Endocrine, Hepato\u2010Biliary, Pancreatic and Liver Transplant Surgery,Trousseau Hospital,Tours,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephrem","family":"Salam\u00e9","sequence":"additional","affiliation":[{"name":"Department of Digestive, Oncological, Endocrine, Hepato\u2010Biliary, Pancreatic and Liver Transplant Surgery,Trousseau Hospital,Tours,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Pittau","sequence":"additional","affiliation":[{"name":"Centre H\u00e9pato\u2010Biliaire, H\u00f4pital Paul Brousse, Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP),Universit\u00e9 Paris Sud,Villejuif,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc\u2010Antoine","family":"Allard","sequence":"additional","affiliation":[{"name":"Centre H\u00e9pato\u2010Biliaire, H\u00f4pital Paul Brousse, Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP),Universit\u00e9 Paris Sud,Villejuif,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Pradat","sequence":"additional","affiliation":[{"name":"Clinical Research Centre, Hospices Civils de Lyon,Claude Bernard Lyon 1 University,Lyon,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9896-4144","authenticated-orcid":false,"given":"Guillaume","family":"Rossignol","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery & Liver Transplantation, Croix\u2010Rousse Hospital, Hospices Civils de Lyon,Claude Bernard Lyon 1 University,Lyon,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5701-3588","authenticated-orcid":false,"given":"Jean\u2010Yves","family":"Mabrut","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery & Liver Transplantation, Croix\u2010Rousse Hospital, Hospices Civils de Lyon,Claude Bernard Lyon 1 University,Lyon,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rutger J.","family":"Ploeg","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgical Sciences,University of Oxford,Oxford,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Friend","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgical Sciences,University of Oxford,Oxford,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darius F.","family":"Mirza","sequence":"additional","affiliation":[{"name":"Liver Unit, Queen Elizabeth Hospital,University Hospitals Birmingham,Birmingham,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2397-4599","authenticated-orcid":false,"given":"Micka\u00ebl","family":"Lesurtel","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery & Liver Transplantation, Croix\u2010Rousse Hospital, Hospices Civils de Lyon,Claude Bernard Lyon 1 University,Lyon,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Consortium for Organ Preservation in Europe (COPE)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,6,29]]},"reference":[{"key":"lt26522-bib-0001-20250830","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1097\/TP.0000000000003819","article-title":"Donor warm ischemia time in DCD liver 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