{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:12:58Z","timestamp":1789146778056,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"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":["Artificial Organs"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ex situ machine perfusion (EVMP) leads to the accumulation of metabolites and electrolytes in the perfusate. This review aimed to examine the impact of dialysis on biochemical and functional parameters during EVMP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted per PRISMA guidelines. Studies integrating dialysis in lungs, liver, pancreas, and heart EVMP, either in large animals or humans, were included. Biochemical and metabolic parameters, organ weight, inflammatory markers, and organ\u2010specific outcomes were extracted. Meta\u2010analyses and longitudinal regression were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nineteen studies were included. Dialysis maintained sodium (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.17), potassium (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.75), lactate concentrations (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.3), and pH (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.1). A significant decrease was seen in chloride concentration (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), while calcium levels increased significantly over time in the dialysis group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Interleukin 6 was elevated in dialysis relative to the controls during porcine lung perfusion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and trended toward significance in humans (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08). During heart perfusion, the dialysis group exhibited higher cardiac contractility, expressed as a percentage of baseline (71.2%\u2009\u00b1\u20097.7 vs. 55.3%\u2009\u00b1\u20098.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). During liver perfusion, bile production increased significantly from baseline (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009+1.85\u2009IU\/L\/h,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Lung compliance was stable in the dialysis (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22122.34\u2009mL\/H\n                      <jats:sub>2<\/jats:sub>\n                      O\/h,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.36) and control groups (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009+0.12\u2009mL\/H\n                      <jats:sub>2<\/jats:sub>\n                      O\/h,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.27).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dialysis maintained biochemical homeostasis during EVMP. Significant functional benefits were seen in cardiac EVMP and should be investigated in other organs, including appropriate control groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.70011","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T13:00:44Z","timestamp":1759842044000},"page":"13-29","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Integrating Dialysis in Ex Situ Machine Perfusion: A Systematic Review and Meta\u2010Analysis of Outcomes"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6907-0339","authenticated-orcid":false,"given":"Yomna E.","family":"Dean","sequence":"first","affiliation":[{"name":"Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Frisbie","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Foundation  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Zurich  Zurich Switzerland"},{"name":"Macromolecular Engineering Laboratory, Department of Mechanical and Process Engineering ETH Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Pfister","sequence":"additional","affiliation":[{"name":"Hub for Translational Research and Liver\/GI Health  Zurich Switzerland"},{"name":"Faculty of Medicine University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Binz","sequence":"additional","affiliation":[{"name":"Hub for Translational Research and Liver\/GI Health  Zurich Switzerland"},{"name":"Faculty of Medicine University of Zurich  Zurich Switzerland"},{"name":"Macromolecular Engineering Laboratory, Department of Mechanical and Process Engineering ETH Zurich  Zurich 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