{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:19:50Z","timestamp":1787681990852,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>As normothermic machine perfusion (NMP) maintains liver grafts in a near\u2010physiologic state, uncoupling ischemia\u2013reperfusion injury from the recipient, the validity of early graft dysfunction scores from the static cold storage (SCS) era are uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All liver grafts that were transplanted following NMP at our center between 08\/19\/2022 and 05\/31\/2024 were analyzed. We assessed associations between the early graft dysfunction scores and graft survival in the NMP era and identified factors linked to pronounced dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 126 NMP\u2010perfused liver grafts, seven (5.5%) were discarded after viability assessment. Among the 107 transplanted livers (41%\u2010DBD, 59%\u2010DCD), neither the liver graft assessment following transplantation (L\u2010GrAFT7) nor the model for early allograft function (MEAF) scores correlated with early graft loss. Early allograft dysfunction (EAD) occurred in 40% of cases and was associated with lower 6\u2011month graft survival compared with non\u2010EAD cases (89%\u00a0vs 100%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.04). Higher donor BMI, longer agonal and anastomosis times, post\u2010reperfusion syndrome, and suboptimal pump parameters (impaired glucose metabolism, delayed lactate clearance, increased bicarbonate use, elevated perfusate transaminases) correlated with EAD. Grafts exceeding conventional viability thresholds (increased bicarbonate use to maintain pH &gt;7.2, lactate rise &gt;2\u00a0mmol\/L within 6 h post\u2010clearance, and perfusate ALT &gt;6000\u00a0U\/L) were successfully utilized without compromising short\u2010term outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the NMP era, EAD identifies a high\u2010risk subgroup with inferior short\u2010term graft survival. Trajectory\u2010based scores did not correlate with early graft loss. Pump variables may help guide decision\u2010making when considering the use of liver grafts with an increased likelihood of EAD in select recipients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70632","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T08:36:21Z","timestamp":1785918981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing Early Graft Dysfunction Scores in Liver Transplantation After Ex\u2010Situ Normothermic Machine Perfusion"],"prefix":"10.1111","volume":"40","author":[{"given":"Kejal","family":"Shah","sequence":"first","affiliation":[{"name":"Division of Transplantation, Department of Surgery The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Castellanos","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April J.","family":"Logan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonid","family":"Gorelik","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelise","family":"Nolan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Iyer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Ohio State University Wexner Medical Center  Columbus Ohio 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