{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T06:48:18Z","timestamp":1791787698649,"version":"4.3.4"},"reference-count":14,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Normothermic regional perfusion (NRP) during donation after circulatory death (DCD) improves abdominal organ utilization by limiting warm ischemia time. Its application in young pediatric donors remains exceptionally rare; the youngest previously reported DCD\u2010NRP donor in the United States was 5\u2009years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe DCD\u2010NRP organ procurement from a 23\u2010month\u2010old donor and the subsequent use of the liver graft in a domino liver transplantation involving two pediatric recipients. The kidneys were recovered en bloc. The donor, supported on veno\u2010arterial extracorporeal membrane oxygenation (VA\u2010ECMO) following hypoxic\u2013ischemic injury, underwent DCD\u2010NRP using the preexisting ECMO cannulation after thoracic exclusion of the cerebral and coronary circulations. The recovered graft was transplanted into a 4\u2010year\u2010old with maple syrup urine disease (MSUD), whose explanted native liver was then used as a domino graft for an 18\u2010month\u2010old with biliary atresia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>NRP was established rapidly with restoration of metabolic activity, and both transplants were technically successful with good early graft function. The MSUD recipient underwent re\u2010laparotomy for a suspected intra\u2010abdominal source of sepsis (no anastomotic leak identified; cultures negative) and recovered with appropriately trending branched\u2010chain amino acid levels, and was discharged on posttransplant Day 17. The domino recipient had an uncomplicated course and was discharged on posttransplant Day 6.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>To our knowledge, this is the youngest DCD\u2010NRP liver donor reported in the United States and the youngest domino liver transplantation performed using a DCD\u2010NRP graft. Deliberately pairing NRP with domino transplantation may synergistically expand the critically limited pediatric donor pool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70498","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:16:11Z","timestamp":1791778571000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Expanding the Donor Pool in Pediatric Transplantations: Successful Domino Liver Transplantation From the Youngest Reported Pediatric\n                    <scp>DCD<\/scp>\n                    Donor Using Normothermic Regional Perfusion in the United States"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0934-056X","authenticated-orcid":false,"given":"Anastasia M.","family":"Kahan","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9272-5618","authenticated-orcid":false,"given":"Francisca","family":"van der Schyff","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-2240","authenticated-orcid":false,"given":"Alan G.","family":"Contreras","sequence":"additional","affiliation":[{"name":"Department of Surgery, Department of Transplant Surgery Intermountain Health  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dave N.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Anesthesia University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3072-0554","authenticated-orcid":false,"given":"M. Kyle","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Gastroenterology, Hepatology, &amp; Nutrition University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Sweney","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey N.","family":"Troy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean F.","family":"Botha","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery University of Utah  Salt Lake City Utah USA"},{"name":"Department of Surgery, Department of Transplant Surgery Intermountain Health  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2561-7539","authenticated-orcid":false,"given":"Zachary J.","family":"Kastenberg","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2024.13263"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000005114"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000001144"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2022.12.021"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.70198"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.06.053"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.70111"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14234"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/frtra.2024.1320783"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/3527865"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp0804474"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14603"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13721"},{"key":"e_1_2_8_15_1","unstructured":"Organ Procurement and Transplantation Network Policies \u201cHealth Resources & Services Administration \u201d(2026) https:\/\/www.hrsa.gov\/sites\/default\/files\/hrsa\/optn\/optn_policies.pdf."}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70498","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.70498","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70498","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T06:30:05Z","timestamp":1791786605000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70498"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":14,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/petr.70498"],"URL":"https:\/\/doi.org\/10.1111\/petr.70498","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-06-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70498"}}