{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:50:45Z","timestamp":1791345045388,"version":"4.3.1"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Organ donation after determination of death by neurological criteria (DBD) remains a cornerstone of deceased donation programs, yet the full pathway from donor identification to organ retrieval, transplantation, and early graft function remains insufficiently described. A better understanding of where falls occurs along this trajectory may help identify modifiable barriers and improve donation\u2010system performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective single\u2010center observational study including all consecutive cases of patients who underwent determination of death by neurological criteria recorded between 2019\u20132025 in four intensive care units of a tertiary\u2010care hospital in Northern Italy. Data were extracted from institutional clinical and donation records and included donor characteristics, recorded donation preference, family authorization, causes of non\u2010retrieval, number and type of organs retrieved and transplanted, and early graft functional recovery (e.g., 24\u201348\u00a0h posttransplant).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>155 patients underwent determination of death by neurological criteria. Organ retrieval was performed in 111 cases (71.6%). Documented prior consent was present in 41 cases (26.4%), decline in 3 (1.9%), and no prior recorded donation preference in 106 cases (68.4%), requiring family authorization. In this subgroup, family decline occurred in 27 cases (25.5%) and represented the leading cause of non\u2010retrieval. Medical contraindications accounted for 12 further exclusions. Overall, 365 organs were retrieved, corresponding to 65.8% of potentially available organs; 343 (94.0%) were transplanted, and 332 (96.8% of transplanted organs) showed functional recovery at 24\u201348\u00a0h. Mean number of retrieved organs was 3.28, with 2.99 functioning grafts per donor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Family decline and non\u2010retrieval of organs judged unsuitable at retrieval were the main points of loss along the donation pathway. Systematic whole\u2010pathway data collection may help identify missed opportunities, guide quality\u2010improvement strategies, and optimize assessment at the organ retrieval stage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70668","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:16:11Z","timestamp":1789020971000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Determination of Death by Neurological Criteria to Early Graft Function: A 7\u2010Year Single\u2010Center Retrospective Study of 155 Consecutive Cases"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2352-6756","authenticated-orcid":false,"given":"Alessandra Agnese","family":"Grossi","sequence":"first","affiliation":[{"name":"Research Center for Clinical Ethics, Department of Biotechnologies and Life Sciences University of Insubria Varese Italy"},{"name":"Department of Human Sciences, Innovation and Territory University of Insubria  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4232-1713","authenticated-orcid":false,"given":"Baiardo Redaelli","family":"Martina","sequence":"additional","affiliation":[{"name":"Department of Biotechnologies and Life Sciences University of Insubria  Varese Italy"},{"name":"General and Neurosurgical Intensive Care Units, Ospedale di Circolo e Fondazione Macchi ASST Sette Laghi  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"De Min","sequence":"additional","affiliation":[{"name":"General and Neurosurgical Intensive Care Units, Ospedale di Circolo e Fondazione Macchi ASST Sette Laghi  Varese Italy"},{"name":"Organ Procurement Hospital Organization ASST Sette Laghi  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Assunta","family":"Donato","sequence":"additional","affiliation":[{"name":"Organ Procurement Hospital Organization ASST Sette Laghi  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6628-4935","authenticated-orcid":false,"given":"Alessia","family":"Bresil","sequence":"additional","affiliation":[{"name":"Organ Procurement Hospital Organization ASST Sette Laghi  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro Ivan","family":"De Martino","sequence":"additional","affiliation":[{"name":"General and Neurosurgical Intensive Care Units, Ospedale di Circolo e Fondazione Macchi ASST Sette Laghi  Varese Italy"},{"name":"Organ Procurement Hospital Organization ASST Sette Laghi  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8027-0059","authenticated-orcid":false,"given":"Paolo","family":"Severgnini","sequence":"additional","affiliation":[{"name":"Department of Biotechnologies and Life Sciences University of Insubria  Varese Italy"},{"name":"Cardiological Anesthesia and Intensive Care Unit, Circolo Hospital ASST Sette Laghi  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8927-1197","authenticated-orcid":false,"given":"Luca","family":"Cabrini","sequence":"additional","affiliation":[{"name":"Department of Biotechnologies and Life Sciences University of Insubria  Varese Italy"},{"name":"General and Neurosurgical Intensive Care Units, Ospedale di Circolo e Fondazione Macchi ASST Sette Laghi  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000005657"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.AJT.2025.01.026"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/NDT\/GFAC300"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/NICC.12462"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.7182\/PIT2013801"},{"key":"e_1_2_11_7_1","unstructured":"NHS Blood and Transplant. \u201cPotential Donor Audit: Annual Report \u201d1 April 2024\u201331 March 2025.2025. Accessed July 15 2026 https:\/\/nhsbtdbe.blob.core.windows.net\/umbraco\u2010assets\u2010corp\/36770\/annual\u2010pda\u2010report\u20101\u2010april\u20102024\u201031\u2010march\u20102025.pdf."},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.AJT.2026.05.718"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/S44158\u2010025\u201000301\u20107"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/TI.2023.11674\/BIBTEX"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2023.11216"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1558\/cam.21434"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.KINT.2018.02.016"},{"key":"e_1_2_11_14_1","unstructured":"Italian National Transplant Center (CNT). \u201cDonation and Transplantation of Organs Tissues and Hematopoietic Stem Cells: Preliminary Report 2025 \u201d2026. Accessed May 1 2026 https:\/\/www.trapianti.salute.gov.it\/sites\/default\/files\/2026\u201003\/Report%20Preliminare%20Integrazione_2025_R3.pdf."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/TI.2023.11186\/PDF"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ANAE.13535"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000000513"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/S13690\u2010025\u201001559\u20107"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003616"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0B013E318256A45F"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/17538068.2025.2462424"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/CTR.12319"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/23814683251386881"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.TRANSPROCEED.2019.01.158"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000540304"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70668","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.70668","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70668","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:15:52Z","timestamp":1791342952000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/ctr.70668"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70668","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-05-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70668"}}