{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:19:37Z","timestamp":1787681977804,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/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>Background<\/jats:title>\n                    <jats:p>Hypothermic machine perfusion (HMP), an organ preservation technique used in deceased donor kidney transplantation, improves early outcomes compared to traditional static cold storage while also providing a loosely validated organ viability assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We designed a survey to better understand the practices, perceptions, and barriers to utilization of HMP. Surgeons, nephrologists, and coordinators were invited to participate in the survey via email.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Respondents (90% transplant surgeons) from 88 transplant centers which utilize HMP (35% of active kidney transplant centers) participated, representing 63% of total transplant volume in 2024. Respondents strongly agreed that HMP is helpful in kidney selection (92%), reduces delayed graft function (90%), and allows for scheduling flexibility (91%). A majority (74%) answered that the Organ Procurement Organization (OPO exclusively pumps kidneys. The most cited barrier to HMP use was OPO refusal (58%). Thresholds for resistance and flow varied widely with over 2\/3 of respondents citing a specified acceptable cut\u2010off. Most respondents answered \u201csometimes\u201d (60%) or \u201cyes\u201d (20%) that they would decline a kidney if HMP could not be accomplished for a kidney they wished to be pumped. Perceived pitfalls were underutilization of kidneys due to incorrect or inaccurate perfusion parameters, logistical challenges and costs of pumping, inexperience and technical difficulties leading to organ or vasculature injury, and lack of standardization in practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HMP is used as a tool to assess organ viability and to overcome logistical hurdles by improving flexibility in operative timing. OPOs play a critical role in the ability to perform HMP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70637","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T12:10:20Z","timestamp":1786363820000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypothermic Machine Perfusion in Deceased Donor Kidney Transplantation: Provider and Transplant Center Practices and Perspectives"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-6756","authenticated-orcid":false,"given":"Beatrice P.","family":"Concepcion","sequence":"first","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Binari","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5944-0366","authenticated-orcid":false,"given":"Vasanthi","family":"Balaraman","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Science Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angie","family":"Nishio\u2010Lucar","sequence":"additional","affiliation":[{"name":"University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0785-8467","authenticated-orcid":false,"given":"Anju","family":"Yadav","sequence":"additional","affiliation":[{"name":"Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5535-9908","authenticated-orcid":false,"given":"Ankita","family":"Patel","sequence":"additional","affiliation":[{"name":"Recanati\u2010Miller Transplantation Institute The Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7495-3758","authenticated-orcid":false,"given":"Kenneth J.","family":"Woodside","sequence":"additional","affiliation":[{"name":"Sharing Hope South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-4849","authenticated-orcid":false,"given":"Krista L.","family":"Lentine","sequence":"additional","affiliation":[{"name":"SSM Health Saint Louis University Hospital Transplant Center  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5968-9899","authenticated-orcid":false,"given":"M. Lee","family":"Sanders","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3212-5831","authenticated-orcid":false,"given":"Oluwafisayo O.","family":"Adebiyi","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2332-828X","authenticated-orcid":false,"given":"Sabiha M.","family":"Hussain","sequence":"additional","affiliation":[{"name":"Penn Transplant Institute Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikha","family":"Mehta","sequence":"additional","affiliation":[{"name":"University of Alabama  Birmingham Alabama 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