{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:23:41Z","timestamp":1785252221490,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Efforts to improve the quality of marginal grafts for transplantation are essential. Machine perfusion preservation appears as a promising solution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The United Network for Organ Sharing (UNOS) database was queried for deceased liver donor records between 2016 and 2022. The primary outcome of interest was the organ nonutilization rate. Long\u2010term graft and patient survival among extended criteria donors (ECDs) were also analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, out of 54\u2009578 liver grafts recovered for transplant, 5085 (9.3%) were nonutilized. Multivariable analysis identified normothermic machine perfusion (NMP) preservation as the only predictor associated with a reduction in graft nonutilization (OR\u2009=\u20090.12; 95% CI\u2009=\u20090.06\u20130.023, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Further analysis of ECD grafts that were transplanted revealed comparable 1\u2010,2\u2010 and 3\u2010years graft survival (89%\/88%\/82% vs. 90%\/85%\/81%, <jats:italic>p<\/jats:italic>\u2009=\u20090.60), and patient survival (92%\/91%\/84% vs. 92%\/88%\/84%, <jats:italic>p<\/jats:italic>\u2009=\u20090.65) between grafts that underwent MP vs. those who did not, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Liver nonutilization rates in the United States are at an all\u2010time high. Available data, most likely including cases from clinical trials, showed that NMP reduced the odds of organ nonutilization by 12% among the entire deceased donor pool and by 16% among grafts from ECD. Collective efforts and further evidence reflecting day\u2010to\u2010day clinical practice are needed to fully reach the potential of MP for liver transplant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14812","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T08:40:03Z","timestamp":1721637603000},"page":"1275-1287","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Are we on track to increase organ utilization? An analysis of machine perfusion preservation for liver transplantation in the United States"],"prefix":"10.1111","volume":"48","author":[{"given":"Todd","family":"Robinson","sequence":"first","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery University of Virginia Health System  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8038-6665","authenticated-orcid":false,"given":"Paola A.","family":"Vargas","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery University of Virginia Health System  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renana","family":"Yemini","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery University of Virginia Health System  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Goldaracena","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery University of Virginia Health System  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Pelletier","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery University of Virginia Health System  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.02.006"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2016.12.004"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2006.07.016"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840200410"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2006.07.018"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2006.07.017"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/frtra.2023.1163539"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02932.x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.11.023"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001473"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.10.005"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003513"},{"key":"e_1_2_11_14_1","unstructured":"Organ Procurement and Transplantation Network. 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