{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:32:59Z","timestamp":1780576379445,"version":"3.54.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","award":["RC-2025-2791682"],"award-info":[{"award-number":["RC-2025-2791682"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Extended criteria donors (ECDs) have become an important source of organs, but their association with infection risk remains unclear. This systematic review assessed the impact of ECD versus standard criteria donors (SCDs) on infection rates in kidney and liver transplant recipients and analyzed the variability of ECD definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three different literature databases were searched up to June 2024 for randomized controlled trials or observational studies comparing infection rates between ECD and SCD recipients. Studies without quantitative data or comparator groups were excluded. Outcomes were measured at 30\u2013180 days and 1, 3, and 5 years posttransplant, evaluating both bacterial and viral infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 11 119 articles were screened and 131 studies included. At 30 days, bacterial infections occurred at similar rates between ECD and SCD recipients (odds ratio [OR] 1.15, 95% confidence interval [CI] .86\u20131.53, P = .36). However, liver transplant recipients from ECDs had a higher infection risk (OR 1.73, 95% CI 1.12\u20132.68, P = .01). Definitions of ECD varied notably, especially in liver transplantation, while kidney transplantation criteria were more consistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Current evidence does not definitively establish a link between ECD and infection risk, highlighting the need for standardized donor definitions and routine reporting of infections as ECD outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag187","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:45:36Z","timestamp":1774615536000},"source":"Crossref","is-referenced-by-count":1,"title":["Impact of Extended Criteria Donor Transplants on Infections in Kidney and Liver Transplant Recipients and Marginal Donor Definition Criteria: A Systematic Review"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5661-1324","authenticated-orcid":false,"given":"Cecilia","family":"Bonazzetti","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]},{"name":"Infectious Diseases Unit, Department of Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3018-3779","authenticated-orcid":false,"given":"Milo","family":"Gatti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]},{"name":"Clinical Pharmacology Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Clara","family":"Chionsini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7300-3918","authenticated-orcid":false,"given":"Chiara","family":"Calgarini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Casarini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6448-5607","authenticated-orcid":false,"given":"Luca","family":"Ceccarelli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3568-5973","authenticated-orcid":false,"given":"Matteo","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]},{"name":"Infectious Diseases Unit, Department of Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Comai","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Morelli","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit for the Treatment of Severe Organ Failure, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana","family":"Laici","sequence":"additional","affiliation":[{"name":"Division of Anesthesiology, Department of Anesthesia and Intensive Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Siniscalchi","sequence":"additional","affiliation":[{"name":"Division of Anesthesiology, Department of Anesthesia and Intensive Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Ravaioli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna , Bologna ,","place":["Italy"]},{"name":"Hepato-biliary and Transplant Unit, IRCCS AOUBO , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Alvaro","sequence":"additional","affiliation":[{"name":"Regional Transplant Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna 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