{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:02:29Z","timestamp":1790694149875,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"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":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n The shortage of donor organs has increased the use of extended criteria donor (ECD) grafts in liver transplantation. Normothermic machine perfusion (NMP) could be used as a platform for real\u2010time quality assessment, which is crucial since ECD grafts are more susceptible to ischemia\u2013reperfusion injury (IRI). As nicotinamide adenine dinucleotide (NAD\n +<\/jats:sup>\n ) is a central mediator of cellular antioxidativedefense, reduced intracellular NAD (iNAD\n +<\/jats:sup>\n ) levels in grafts sustaining greater injury may reflect diminished antioxidative capacity and could serve as a marker to assess graft quality. This study aimed to investigate iNAD\n +<\/jats:sup>\n in comparison to existing damage\u2010associated parameters for liver graft quality in a small animal NMP model simulating ECD conditions through advanced donor age, prolonged cold ischemia time (CIT), and donation after circulatory death (DCD).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Fifty\u2010nine male Sprague\u2013Dawley rat livers were analyzed across six experimental groups defined by donor age (3\u2009months [young] or 12\u2009months [elderly]), procurement modality (standard procurement or donation after circulatory death [DCD]), and cold ischemia time (CIT; 6\u2009h or 12\u2009h), followed by 6\u2009h of NMP. No livers were excluded from analysis. iNAD\n +<\/jats:sup>\n levels were quantified using a colorimetric enzymatic assay.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Perfusate iNAD\n +<\/jats:sup>\n levels continuously rose over time during NMP and differed significantly between intervention groups (\n p<\/jats:italic>\n \u2009=\u20090.003). iNAD+ correlated negatively with ALT levels (R\u2009=\u2009\u22120.36,\n p<\/jats:italic>\n \u2009=\u20090.024) and liver tissue necrosis in grafts (perfusate R\u2009=\u2009\u22120.24,\n p<\/jats:italic>\n \u2009=\u20090.17; tissue R\u2009=\u2009\u22120.19,\n p<\/jats:italic>\n \u2009=\u20090.2), although these associations did not reach statistical significance. Long CIT, higher donor age, and DCD procurement were associated with lower iNAD+ levels. iNAD+ did not correlate with lactate clearance or bile production (both\n p<\/jats:italic>\n \u2009>\u20090.05). A non\u2010significant trend toward a positive association between iNAD+ and glucose metabolism was observed (\n R<\/jats:italic>\n \u2009=\u20090.29,\n p<\/jats:italic>\n \u2009=\u20090.077).\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Higher perfusate iNAD+ levels were associated with better organ performance, consistent with iNAD+ reflecting the graft's antioxidative metabolic capacity. Lower iNAD+ levels in elderly and DCD grafts aligned with established damage markers. Perfusate iNAD+ may therefore offer a complementary tool for evaluating metabolic activity and organ performance during NMP, pending prospective validation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aor.70197","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:15:03Z","timestamp":1785212103000},"page":"1384-1395","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nicotinamide Adenine Dinucleotide as a Potential Biomarker for Graft Viability During Normothermic Machine Perfusion: An Ex\u00a0Vivo Rodent Study"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4853-6441","authenticated-orcid":false,"given":"Kilian A.","family":"Walter","sequence":"first","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin, Department of Surgery, Experimental Surgery, Campus Charit\u00e9 Mitte Campus Virchow\u2010Klinikum Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1238-8984","authenticated-orcid":false,"given":"Leonard","family":"Boerger","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin, Department of Surgery, Experimental Surgery, Campus Charit\u00e9 Mitte Campus Virchow\u2010Klinikum Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6056-5262","authenticated-orcid":false,"given":"Anna","family":"Pietsch","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin, Department of Surgery, Experimental Surgery, Campus Charit\u00e9 Mitte Campus Virchow\u2010Klinikum Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Gilles","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin, Department of Surgery, Experimental Surgery, Campus Charit\u00e9 Mitte Campus Virchow\u2010Klinikum Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0357-0394","authenticated-orcid":false,"given":"Phillip","family":"Brunnbauer","sequence":"additional","affiliation":[{"name":"DeepSpin GmbH Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1190-6775","authenticated-orcid":false,"given":"Can","family":"Kamali","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate 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