{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:24Z","timestamp":1787013864086,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Liver transplantation (LT) is the sole curative option for liver failure and other primary liver conditions. However, the limited number of suitable donors compared with the growing number of patients requiring LT remains a leading cause of mortality among those on the waiting list. This has resulted in the expansion of criteria for donor eligibility. The sequential combination of ex situ reperfusion, dHOPE, and NMP helps reduce the occurrence of ischemia\u2013reperfusion injury and assess organ viability prior to transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective, single\u2010arm, single\u2010center study including all cases of liver grafts that underwent sequential perfusion between October 2021 and July 2024. Eligibility criteria for sequential perfusion were extended criteria DBD with macrosteatosis &gt;\u200935%, use of high\u2010dose vasopressors during donor ICU stay or episodes of cardiac arrest, hemodynamic instability during procurement, prolonged ischemia time for logistic reasons, as well as DCD showing prolonged fWIT, flow alteration during normothermic regional perfusion (NRP), and DCDs in Maastricht 2 class. Viability was assessed following the Groeningen group criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010three cases were included and 16 met the viability criteria at the end of the sequential perfusion and were transplanted. One patient developed an early allograft failure (EAF) and another a primary nonfunction (PNF). All the other patients had a regular postoperative course, with no retransplantation, 56% of the cohort showing no postoperative complication and all currently in good standing, median follow\u2010up 19\u2009months (range 4\u201339).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sequential dHOPE and NMP is a strategy that can help assessing both viability and functionality of liver grafts from high\u2010risk donors, expanding the donor pool and increasing the opportunities for patients on the waiting list to get a transplant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.14936","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T08:33:56Z","timestamp":1739954036000},"page":"705-715","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Sequential Hypothermic and Normothermic Machine Perfusion of Extended Criteria Donors in Liver Transplantation: A Single\u2010Center Preliminary Experience"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8326-069X","authenticated-orcid":false,"given":"Paolo","family":"Magistri","sequence":"first","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena \u201cPoliclinico\u201d University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Zamboni","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena \u201cPoliclinico\u201d University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Catellani","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena \u201cPoliclinico\u201d University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano","family":"Guidetti","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena \u201cPoliclinico\u201d University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1021-4419","authenticated-orcid":false,"given":"Giuseppe","family":"Esposito","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena \u201cPoliclinico\u201d University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Caracciolo","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena \u201cPoliclinico\u201d University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Odorizzi","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena \u201cPoliclinico\u201d University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Assirati","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena \u201cPoliclinico\u201d University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Olivieri","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena \u201cPoliclinico\u201d University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuele","family":"Frassoni","sequence":"additional","affiliation":[{"name":"Department of Statistics and Quantitative Methods University of Milano\u2010Bicocca  Milan Italy"},{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Bagnardi","sequence":"additional","affiliation":[{"name":"Department of Statistics and Quantitative Methods University of Milano\u2010Bicocca  Milan 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