{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:02:30Z","timestamp":1790694150026,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/Z50502X\/1"],"award-info":[{"award-number":["MR\/Z50502X\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Machine perfusion technology has redefined donor and recipient criteria for liver transplantation. Despite increasing adoption, data regarding graft and recipient factors associated with unsuccessful normothermic machine perfusion (NMP) outcomes remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Organ Procurement and Transplantation Network database was used to retrospectively identify adult patients undergoing deceased donor liver transplantation with NMP preservation between January 10, 2021, and December 31, 2024. Populations were stratified by 1\u2010year graft status, with donor and recipient factors compared. Logistic regression identified factors independently associated with NMP graft failure, and center analyses assessed program\u2010level impacts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 4928 NMP cases, 398 (8.1%) experienced 1\u2010year graft failure. They were more frequently admitted to the intensive care unit (ICU) at transplant (21.1% vs. 10.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and had more complex abdominal histories, including higher rates of TIPS(17.0% vs. 12.0%), prior abdominal surgery (64.1% vs. 54.7%), and prior liver transplant (10.3% vs. 3.4%) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Regression analysis identified increased odds of graft failure with MELD score 35 (aOR 2.10 [1.21\u20133.63]), low recipient functional status (aOR 2.05 [1.31\u20133.21]), and prior abdominal surgery (aOR 1.33 [1.01\u20131.76]). Alcohol\u2010associated liver disease (aOR 0.36 [0.23\u20130.56]) was the only factor conferring a protective effect. Centers with higher\u2010than\u2010expected standardized NMP graft failure rates were higher\u2010volume programs with low\u2010risk case mixes; no centers had persistently high standardized failure rates throughout the study period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Recipient factors, particularly those conferring surgical complexity, are more significantly associated with NMP graft failure than donor factors. Despite increased adoption of perfusion technologies to mitigate donor and operative risk, transplant provider clinical judgment remains critical for optimizing recipient\u2010donor matching and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.70195","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:08:39Z","timestamp":1784365719000},"page":"1407-1417","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When Machine Perfusion Falls Short: Identifying Risks of Liver Graft Failure After Normothermic Machine Perfusion"],"prefix":"10.1111","volume":"50","author":[{"given":"Lauren E.","family":"Matevish","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Surgical Transplantation University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2922-254X","authenticated-orcid":false,"given":"Abdullah K.","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of HPB and Transplant Surgery, Freeman Hospital Newcastle Upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"},{"name":"Newcastle Fibrosis Research Group Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milana","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Transplantation University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9488-7364","authenticated-orcid":false,"given":"Ahmad","family":"Anouti","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor M.","family":"Coe","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Transplantation University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1879-4788","authenticated-orcid":false,"given":"Simon","family":"Moosburner","sequence":"additional","affiliation":[{"name":"Department of Surgery, Campus Charit\u00e9 Mitte Campus Virchow Klinikum, Charit\u00e9, Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin Germany"},{"name":"Biomedical Innovation Academy, BIH Charit\u00e9 Clinician Scientist Program, Berlin Institute of Health at Charit\u00e9, Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5074-7063","authenticated-orcid":false,"given":"Nathanael","family":"Raschzok","sequence":"additional","affiliation":[{"name":"Department of Surgery, Campus Charit\u00e9 Mitte Campus Virchow Klinikum, Charit\u00e9, Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin Germany"},{"name":"Biomedical Innovation Academy, BIH Charit\u00e9 Clinician Scientist Program, Berlin Institute of Health at Charit\u00e9, Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjmand","family":"Mufti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Digestive and Liver Diseases University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parsia A.","family":"Vagefi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Transplantation University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7508-899X","authenticated-orcid":false,"given":"Madhukar S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Transplantation University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Statistics NCfH \u201cChronic Liver Disease and Cirrhosis \u201dCenters for Disease Control and Prevention 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