{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T05:10:37Z","timestamp":1794633037804,"version":"4.9.1"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background.<\/jats:title>\n                    <jats:p>The availability of in situ normothermic regional perfusion (NRP) or ex situ normothermic machine perfusion (NMP) has revolutionized donation after circulatory death (DCD) liver transplant (LT). While some have suggested that NRP and NMP may represent competing technologies for DCD LT, there are many scenarios where these technologies can function in a complementary manner.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>Between January 2022 and March 2024, 83 DCD LTs were performed using NRP (62 NRP alone and 21 NRP + NMP) and were compared with 297 static cold storage (SCS) DCD LTs. NRP + NMP was used in scenarios with (1) long travel distances, (2) complicated transplant recipients, or (c) the need for additional liver graft recovery in \u201cmarginal\u201d cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>\n                      Ischemic cholangiopathy was lower in the NRP alone group (0%) and the NRP + NMP group (0%) compared with the SCS group (16.8;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005&lt;\u20050.001 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005=\u20050.04, respectively). In addition, early allograft dysfunction, number of packed red blood cells transfused, and acute kidney injury were lower in the NRP alone and NRP + NMP groups compared with the SCS group. Graft survival was higher in cases where NRP was used than in cases where SCS was used (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2005=\u20050.016). In all the cases where lactate remained elevated at the end of NRP (mean 8.2\u2005\u00b1\u20052.0), it ultimately normalized at the end of NMP (0.92\u2005\u00b1\u20050.56).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>The present study demonstrates lower rates of ischemic cholangiopathy and improved graft survival with NRP alone or NRP + NMP compared with SCS when using liver grafts from DCD donors. It also demonstrates that excellent outcomes can be achieved with sequential NRP + NMP in cases with prolonged travel distances, complicated recipients, or when there is a need for additional liver recovery in \u201cmarginal\u201d cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/tp.0000000000005301","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:27Z","timestamp":1734998427000},"page":"1184-1190","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":53,"title":["Outcomes of DCD Liver Transplant Using Sequential Normothermic Regional Perfusion and Normothermic Machine Perfusion or NRP Alone Versus Static Cold Storage"],"prefix":"10.1097","volume":"109","author":[{"given":"Kristopher P.","family":"Croome","sequence":"first","affiliation":[{"name":"Department of Transplant, Mayo Clinic Florida, Jacksonville, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Transplant Institute, Tampa General Hospital, Tampa, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit K.","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashar","family":"Aqel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Phoenix, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shennen A.","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Transplant, Mayo Clinic Florida, Jacksonville, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob N.","family":"Clendenon","sequence":"additional","affiliation":[{"name":"Department of Transplant, Mayo Clinic Florida, Jacksonville, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana K.","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Transplant, Mayo Clinic Florida, Jacksonville, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran","family":"Dhanireddy","sequence":"additional","affiliation":[{"name":"Transplant Institute, Tampa General Hospital, Tampa, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Burcin","family":"Taner","sequence":"additional","affiliation":[{"name":"Department of Transplant, Mayo Clinic Florida, Jacksonville, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"R1-20250624","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1097\/01.sla.0000186178.07110.92","article-title":"Donation after cardiac death: the University of Wisconsin experience with liver transplantation.","volume":"242","author":"Foley","year":"2005","journal-title":"Ann Surg"},{"key":"R2-20250624","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.surg.2009.06.052","article-title":"The impact of ischemic cholangiopathy in liver transplantation using donors after cardiac death: the untold story.","volume":"146","author":"Skaro","year":"2009","journal-title":"Surgery"},{"key":"R3-20250624","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1016\/j.jhep.2011.01.040","article-title":"A comprehensive risk assessment of mortality following donation after cardiac death liver transplant\u2014an analysis of the national registry.","volume":"55","author":"Jay","year":"2011","journal-title":"J Hepatol"},{"key":"R4-20250624","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/j.ajt.2024.03.021","article-title":"Should advanced perfusion be the standard of care for donation after circulatory death liver transplant?","volume":"24","author":"Croome","year":"2024","journal-title":"Am J Transplant"},{"key":"R5-20250624","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1111\/ajt.16899","article-title":"Abdominal normothermic regional perfusion in controlled donation after circulatory determination of death liver transplantation: outcomes and risk factors for graft loss.","volume":"22","author":"Hessheimer","year":"2022","journal-title":"Am J Transplant"},{"key":"R6-20250624","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1111\/ajt.15241","article-title":"In situ normothermic perfusion of livers in controlled circulatory death donation may prevent ischemic cholangiopathy and improve graft survival.","volume":"19","author":"Watson","year":"2019","journal-title":"Am J Transplant"},{"key":"R7-20250624","doi-asserted-by":"crossref","first-page":"e14659","DOI":"10.1111\/ctr.14659","article-title":"Early United States experience with liver donation after circulatory determination of death using thoraco-abdominal normothermic regional perfusion: a multi-institutional observational study.","volume":"36","author":"Sellers","year":"2022","journal-title":"Clin Transplant"},{"key":"R8-20250624","first-page":"1282","article-title":"Development of a portable abdominal normothermic regional perfusion (A-NRP) program in the United States.","volume":"29","author":"Croome","year":"2023","journal-title":"Liver Transpl"},{"key":"R9-20250624","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1001\/jamasurg.2024.0520","article-title":"US liver transplant outcomes after normothermic regional perfusion vs standard super rapid recovery.","volume":"159","author":"Brubaker","year":"2024","journal-title":"JAMA Surg"},{"key":"R10-20250624","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1002\/lt.25453","article-title":"Clinical implications of donor warm and cold ischemia time in donor after circulatory death liver transplantation.","volume":"25","author":"Paterno","year":"2019","journal-title":"Liver Transpl"},{"key":"R11-20250624","doi-asserted-by":"crossref","first-page":"10390","DOI":"10.3389\/ti.2022.10390","article-title":"Normothermic Regional perfusion and hypothermic oxygenated machine perfusion for livers donated after controlled circulatory death with prolonged warm ischemia time: a matched comparison with livers from brain-dead donors.","volume":"35","author":"Patrono","year":"2022","journal-title":"Transpl Int"},{"key":"R12-20250624","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.1097\/TP.0000000000003595","article-title":"How to preserve liver grafts from circulatory death with long warm ischemia? A retrospective Italian cohort study with normothermic regional perfusion and hypothermic oxygenated perfusion.","volume":"105","author":"De Carlis","year":"2021","journal-title":"Transplantation"},{"key":"R13-20250624","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1002\/lt.25899","article-title":"Sequential use of normothermic regional and ex situ machine perfusion in donation after circulatory death liver transplant.","volume":"27","author":"Ghinolfi","year":"2021","journal-title":"Liver Transpl"},{"key":"R14-20250624","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1097\/TP.0000000000004963","article-title":"Sequential normothermic regional perfusion and end-ischemic ex situ machine perfusion allow the safe use of very old DCD donors in liver transplantation.","volume":"108","author":"Torri","year":"2024","journal-title":"Transplantation"},{"key":"R15-20250624","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/LVT.0000000000000219","article-title":"Liver transplantation with uncontrolled versus controlled DCD donors using normothermic regional perfusion and ex-situ machine perfusion.","volume":"30","author":"Ghinolfi","year":"2024","journal-title":"Liver Transpl"},{"key":"R16-20250624","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1002\/lt.22091","article-title":"Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors.","volume":"16","author":"Olthoff","year":"2010","journal-title":"Liver Transpl"},{"key":"R17-20250624","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/S1499-3872(12)60194-5","article-title":"Evaluation of the updated definition of early allograft dysfunction in donation after brain death and donation after cardiac death liver allografts.","volume":"11","author":"Croome","year":"2012","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"R18-20250624","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ajt.2022.10.009","article-title":"American Society of Transplant Surgeons recommendations on best practices in donation after circulatory death organ procurement.","volume":"23","author":"Croome","year":"2023","journal-title":"Am J Transplant"},{"key":"R19-20250624","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1097\/TP.0000000000003928","article-title":"Classification of distinct patterns of ischemic cholangiopathy following DCD liver transplantation: distinct clinical courses and long-term outcomes from a multicenter cohort.","volume":"106","author":"Croome","year":"2022","journal-title":"Transplantation"},{"key":"R20-20250624","first-page":"1","article-title":"KDIGO clinical practice guideline for acute kidney injury.","volume":"2","year":"2012","journal-title":"Kidney Int Suppl"},{"key":"R21-20250624","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1097\/SLA.0000000000005428","article-title":"Liver transplantation outcomes from controlled circulatory death donors: SCS vs in situ NRP vs ex situ NMP.","volume":"275","author":"Gaurav","year":"2022","journal-title":"Ann Surg"},{"key":"R22-20250624","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1016\/j.ajt.2024.03.027","article-title":"Association of procurement technique with organ yield and cost following donation after circulatory death.","volume":"24","author":"Bakhtiyar","year":"2024","journal-title":"Am J Transplant"},{"key":"R23-20250624","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1097\/LVT.0000000000000382","article-title":"What is the true cost of DCD liver transplant from a value-based perspective?","volume":"30","author":"Taner","year":"2024","journal-title":"Liver Transpl"}],"container-title":["Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/TP.0000000000005301","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T16:48:25Z","timestamp":1786034905000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/TP.0000000000005301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,24]]},"references-count":23,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/tp.0000000000005301","relation":{},"ISSN":["0041-1337","1534-6080"],"issn-type":[{"value":"0041-1337","type":"print"},{"value":"1534-6080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,24]]}}}