{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:02:09Z","timestamp":1780030929640,"version":"3.53.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>For many patients, liver transplantation (LT) is not feasible due to a shortfall of suitable organs. In Australia, almost all grafts come from deceased donors, a pool not easily expanded, and many potentially useable grafts are declined for viability concerns. Despite this, referral utilisation is incompletely understood. The objective of this paper was to characterise deceased donor liver utilisation and referral patterns at a major Australian LT unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All deceased donor referrals made to the Australian National Liver Transplantation Unit (ANLTU) from 2014 to 2024 were included. The primary endpoint was the utilisation rate of referrals made to the ANLTU. Secondary endpoints included the effect of referring hospital location on utilisation, reason for decline and donor characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1649 referrals were included. During the study period, out\u2010of\u2010network referral volume increased significantly, from 23 to 77 annually (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044). Overall, utilisation fell from 61.3% to 43.2% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045), due to falling utilisation of out\u2010of\u2010network referrals. In\u2010network donation after neurological determination of death (DNDD) and circulatory determination of death (DCDD) referral utilisation was stable at 65.3% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.979) and 30.0% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.621), respectively. In\u2010network referrals were increasingly declined due to an absence of a suitable potential recipient (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and out\u2010of\u2010network due to the graft being unsuitable for the urgently listed patient (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Utilisation of in\u2010network referrals has remained unchanged since 2014. Out\u2010of\u2010network referral volume is increasing, with reduced utilisation of grafts amongst this cohort. Techniques to improve organ utilisation will be critical to expand access to LT in Australia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70662","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T05:40:44Z","timestamp":1776318044000},"page":"1310-1319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Plateauing Deceased Donor Liver Utilisation Presents Emerging Challenges for Liver Transplantation in Australia"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7072-2160","authenticated-orcid":false,"given":"Charles W. G.","family":"Risbey","sequence":"first","affiliation":[{"name":"Department of Transplant Surgery Royal Prince Alfred Hospital  Camperdown New South Wales Australia"},{"name":"Centre for Organ Assessment, Repair, &amp; Optimization (COARO)  Camperdown New South Wales Australia"},{"name":"Central Clinical School The University of Sydney. John Hopkins Dr  Camperdown New South Wales Australia"},{"name":"Australian National Liver Transplantation Unit (ANLTU), Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Dabrowski","sequence":"additional","affiliation":[{"name":"Central Clinical School The University of Sydney. John Hopkins Dr  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Virtue","sequence":"additional","affiliation":[{"name":"Australian National Liver Transplantation Unit (ANLTU), Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"West","sequence":"additional","affiliation":[{"name":"Australian National Liver Transplantation Unit (ANLTU), Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0453-3168","authenticated-orcid":false,"given":"Ken","family":"Liu","sequence":"additional","affiliation":[{"name":"Central Clinical School The University of Sydney. John Hopkins Dr  Camperdown New South Wales Australia"},{"name":"Australian National Liver Transplantation Unit (ANLTU), Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone I.","family":"Strasser","sequence":"additional","affiliation":[{"name":"Central Clinical School The University of Sydney. John Hopkins Dr  Camperdown New South Wales Australia"},{"name":"Australian National Liver Transplantation Unit (ANLTU), Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey W.","family":"McCaughan","sequence":"additional","affiliation":[{"name":"Centre for Organ Assessment, Repair, &amp; Optimization (COARO)  Camperdown New South Wales Australia"},{"name":"Central Clinical School The University of Sydney. John Hopkins Dr  Camperdown New South Wales Australia"},{"name":"Australian National Liver Transplantation Unit (ANLTU), Royal Prince Alfred Hospital  Camperdown New South Wales Australia"},{"name":"Liver Injury and Cancer Program Centenary Institute, the University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Crawford","sequence":"additional","affiliation":[{"name":"Department of Transplant Surgery Royal Prince Alfred Hospital  Camperdown New South Wales Australia"},{"name":"Centre for Organ Assessment, Repair, &amp; Optimization (COARO)  Camperdown New South Wales Australia"},{"name":"Central Clinical School The University of Sydney. John Hopkins Dr  Camperdown New South Wales Australia"},{"name":"Australian National Liver Transplantation Unit (ANLTU), Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Pulitano","sequence":"additional","affiliation":[{"name":"Department of Transplant Surgery Royal Prince Alfred Hospital  Camperdown New South Wales Australia"},{"name":"Centre for Organ Assessment, Repair, &amp; Optimization (COARO)  Camperdown New South Wales Australia"},{"name":"Central Clinical School The University of Sydney. John Hopkins Dr  Camperdown New South Wales Australia"},{"name":"Australian National Liver Transplantation Unit (ANLTU), Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"The Transplantation Society of Australia and New Zealand \u201cClinical Guidelines for Organ Transplantation from Deceased Donors. V1.15. [Internet] \u201dNovember 2025 accessed March 5 2026 https:\/\/tsanz.com.au\/storage\/Guidelines\/TSANZ_Clinical_Guidelines_Version\u2010115_101225.pdf."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2010.02277.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24462"},{"key":"e_1_2_10_5_1","unstructured":"Australia and New Zealand Liver and Intestinal Transplant Registry \u201c34th Annual Report. 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