{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T07:37:21Z","timestamp":1793345841765,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Normothermic machine perfusion (NMP) allows for the assessment and resuscitation of ex\u2010vivo human livers prior to transplantation. Commercially available NMP systems are closed circuits that accumulate metabolic waste and cytokines over time, potentially limiting organ preservation times. Dialysis has been proposed as a method to remove waste and excess fluid from such systems. This study aimed to demonstrate the utility of integrating dialysis into a commercially available system by quantifying solute removal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A dialysis filter was attached in parallel to a commercially available liver perfusion system. Three livers declined for transplantation were split before undergoing long\u2010term NMP with blood using the modified system. During perfusion, dialysate flow rates were set in the range of 100\u2013600\u2009mL\/h for short periods of time. At each flow rate, perfusate and spent dialysate samples were collected and analyzed for solute clearance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The addition of dialysis to a commercial NMP system removed water\u2010soluble waste and helped regulate electrolyte concentrations. Interleukin\u20106 was successfully removed from the perfusate. Solute clearance was proportional to dialysate flow rate. A guide for our perfusion setup was created for the appropriate selection of dialysis flow rates and duration based on real\u2010time perfusate composition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dialysis circuits can efficiently remove waste and regulate perfusate composition, and can be easily incorporated to improve the performance of commercially available systems. Quantification of the effect of dialysis on perfusate composition enables refined dialysis control to optimize electrolyte profiles and avoid the over\u2010 or under\u2010correction of key solutes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14749","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T06:32:00Z","timestamp":1711434720000},"page":"1008-1017","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Incorporating a hemodialysis filter into a commercial normothermic perfusion system to facilitate long\u2010term preservation of human split\u2010livers"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7202-2143","authenticated-orcid":false,"given":"Joanna","family":"Huang","sequence":"first","affiliation":[{"name":"Australian National Liver Transplantation Unit Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Centre for Organ Assessment, Repair and Optimisation Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2254-8574","authenticated-orcid":false,"given":"Ngee\u2010Soon","family":"Lau","sequence":"additional","affiliation":[{"name":"Australian National Liver Transplantation Unit Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Centre for Organ Assessment, Repair and Optimisation Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Ly","sequence":"additional","affiliation":[{"name":"Australian National Liver Transplantation Unit Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Centre for Organ Assessment, Repair and Optimisation Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Babekuhl","sequence":"additional","affiliation":[{"name":"Centre for Organ Assessment, Repair and Optimisation Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Yousif","sequence":"additional","affiliation":[{"name":"Australian National Liver Transplantation Unit Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Centre for Organ Assessment, Repair and Optimisation Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Liu","sequence":"additional","affiliation":[{"name":"Australian National Liver Transplantation Unit Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff","family":"McCaughan","sequence":"additional","affiliation":[{"name":"Australian National Liver Transplantation Unit Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Crawford","sequence":"additional","affiliation":[{"name":"Australian National Liver Transplantation Unit Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Centre for Organ Assessment, Repair and Optimisation Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4420-4107","authenticated-orcid":false,"given":"Carlo","family":"Pulitano","sequence":"additional","affiliation":[{"name":"Australian National Liver Transplantation Unit Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Centre for Organ Assessment, Repair and Optimisation Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41587-019-0374-x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/tgh.2019.08.12"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000000864"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24094"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.13579"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24451"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25360"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000001216"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-40154-8"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.14372"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2023.02.003"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004653"},{"key":"e_1_2_9_14_1","unstructured":"Baxter.Polyflux 6H Dialyzer.2023[cited 2023 October 12]. Available from:https:\/\/renalcareus.baxter.com\/healthcare\u2010professionalshemodialysis\/polyflux\u20106h\u2010dialyzer"},{"key":"e_1_2_9_15_1","first-page":"179","volume-title":"Pediatric respiratory medicine","author":"Berg M","year":"2008"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1990.149"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-16251-3"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(99)70076-4"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10354-008-0593-0"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1152\/advan.00121.2016"},{"issue":"2","key":"e_1_2_9_21_1","first-page":"466","article-title":"Comprehensive approach to assessment of liver viability during normothermic machine perfusion","volume":"11","author":"Li J","year":"2023","journal-title":"J Clin Transl Hepatol"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58101434"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41587-020-0626-9"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14091"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24603"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.14749","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T15:20:09Z","timestamp":1723562409000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.14749"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,25]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/aor.14749"],"URL":"https:\/\/doi.org\/10.1111\/aor.14749","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,25]]},"assertion":[{"value":"2023-11-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}