{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:05:51Z","timestamp":1789131951316,"version":"build-2803163510"},"reference-count":19,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Cir. Bras."],"abstract":"<jats:p>ABSTRACT  Purpose: To compare the effectiveness of normothermic machine perfusion (NMP) with static cold storage (SCS) in preserving transplantable livers, focusing on early postoperative complications.  Methods: A PRISMA 2020\u2013compliant search of PubMed, Embase, Scopus, Cochrane Library and Web of Science identified comparative studies of NMP versus SCS. Five studies met the criteria (two randomized controlled trials, and three observational cohorts; 630 recipients). Random-effects meta-analysis was performed in RStudio, reporting risk ratio (RR), 95% confidence interval (95%CI), p-value and heterogeneity (I2).  Results: NMP significantly lowered the incidence of composite early postoperative complications versus SCS (RR = 0.60; 95%CI 0.47\u20130.75; p &lt; 0.0001), corresponding to a 40% relative risk reduction. Between-study heterogeneity was negligible (I2 = 0 %). Subgroup analyses revealed no significant effect modification by study design (p = 0.75), donation after circulatory death proportion (p = 0.91), preservation duration (p = 0.51), donor age (p = 0.59) or perfusion technique (p = 0.37).  Conclusion: NMP demonstrates clinically superior graft preservation compared with SCS, consistently reducing early complications after liver transplantation. Adoption of NMP may expand the use of marginal organs and improve post-transplant outcomes.<\/jats:p>","DOI":"10.1590\/acb415326","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:06:59Z","timestamp":1789128419000},"source":"Crossref","is-referenced-by-count":0,"title":["Normothermic machine perfusion versus static cold storage for liver transplantation: a systematic review and meta-analysis"],"prefix":"10.1590","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9434-6136","authenticated-orcid":false,"given":"Miguel Lucas Silva","family":"Valente","sequence":"first","affiliation":[{"name":"Universidade Federal do Acre,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4387-0626","authenticated-orcid":false,"given":"Angela Claudia Paix\u00e3o Soares de","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Universidade Federal do Acre,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4334-1521","authenticated-orcid":false,"given":"Hercules Magalh\u00e3es Olivense do","family":"Carmo","sequence":"additional","affiliation":[{"name":"Universidade Federal do Acre,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1308-0452","authenticated-orcid":false,"given":"Donizete","family":"Dalto Junior","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Hospital Estadual do Acre,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4146-0078","authenticated-orcid":false,"given":"Bryan de Sousa","family":"Dorea","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Hospital Estadual do Acre,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4155-7350","authenticated-orcid":false,"given":"Marina Marcon","family":"Zamban","sequence":"additional","affiliation":[{"name":"Universidade Luterana do Brasil,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"11","key":"ref1","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/j.dld.2016.06.031","article-title":"Liver graft preconditioning, preservation and reconditioning","volume":"48","author":"Gilbo N","year":"2016","journal-title":"Dig Liver Dis"},{"issue":"3","key":"ref2","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s00595-021-02265-x","article-title":"Current review of machine perfusion in liver transplantation from the Japanese perspective","volume":"52","author":"Harada N","year":"2022","journal-title":"Surg Today"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1080\/17474124.2018.1505499","article-title":"Normothermic ex-vivo liver perfusion: where do we stand and where to reach?","volume":"12","author":"Jayant K","year":"2018","journal-title":"Expert Rev Gastroenterol Hepatol"},{"issue":"7703","key":"ref4","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1038\/s41586-018-0047-9","article-title":"A randomized trial of normothermic preservation in liver transplantation","volume":"557","author":"Nasralla D","year":"2018","journal-title":"Nature"},{"issue":"5","key":"ref5","doi-asserted-by":"crossref","DOI":"10.1097\/SLA.0000000000005934","article-title":"Normothermic machine perfusion of donor livers for transplantation in the United States: a randomized controlled trial","volume":"278","author":"Chapman WC","year":"2023","journal-title":"Ann Surg"},{"issue":"9","key":"ref6","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1093\/bjs\/znab118","article-title":"Static cold storage compared with normothermic machine perfusion of the liver","volume":"108","author":"Fodor M","year":"2021","journal-title":"Br J Surg"},{"issue":"6","key":"ref7","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1097\/SLA.0000000000005428","article-title":"Liver transplantation outcomes from controlled circulatory death donors: SCS vs in situ NRP vs ex situ NMP","volume":"275","author":"Gaurav R","year":"2022","journal-title":"Ann Surg"},{"issue":"7","key":"ref8","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1097\/TP.0000000000005301","article-title":"Outcomes of DCD liver transplant using sequential normothermic regional perfusion and normothermic machine perfusion or NRP alone versus static cold storage","volume":"109","author":"Croome KP","year":"2024","journal-title":"Transplantation"},{"issue":"5","key":"ref9","first-page":"596","article-title":"Machine perfusion strategies in liver transplantation: a systematic review and network meta-analysis","volume":"31","author":"Jaber F","year":"2025","journal-title":"Liver Transpl"},{"issue":"9","key":"ref10","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1002\/lt.24515","article-title":"End-ischemic reconditioning of liver allografts: Controlling the rewarming","volume":"22","author":"Hoyer DP","year":"2016","journal-title":"Liver Transpl"},{"issue":"6","key":"ref11","doi-asserted-by":"crossref","first-page":"2816","DOI":"10.3390\/ijms22062816","article-title":"Mitochondrial consequences of organ preservation techniques during liver transplantation","volume":"22","author":"Horv\u00e1th T","year":"2021","journal-title":"Int J Mol Sci"},{"issue":"1","key":"ref12","doi-asserted-by":"crossref","first-page":"23128","DOI":"10.1038\/s41598-021-02417-6","article-title":"The effect of blood cells retained in rat livers during static cold storage on viability outcomes during normothermic machine perfusion","volume":"11","author":"Haque O","year":"2021","journal-title":"Sci 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Res"},{"issue":"9","key":"ref16","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1097\/LVT.0000000000000143","article-title":"Can ex-situ normothermic perfusion improve graft survival compared to static cold storage among DCD liver allografts?","volume":"29","author":"Ibeabuchi T","year":"2023","journal-title":"Liver Transpl"},{"issue":"6","key":"ref17","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1002\/lt.25464","article-title":"A back-to-base experience of human normothermic ex situ liver perfusion: does the chill kill?","volume":"25","author":"Bral M","year":"2019","journal-title":"Liver Transpl"},{"issue":"3","key":"ref18","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1001\/jamasurg.2021.6781","article-title":"Impact of portable normothermic blood-based machine perfusion on outcomes of liver transplant: the OCS Liver PROTECT randomized clinical trial","volume":"157","author":"Markmann JF","year":"2022","journal-title":"JAMA Surg"},{"issue":"3","key":"ref19","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1002\/lt.25362","article-title":"Pilot, open, randomized, prospective trial for normothermic machine perfusion evaluation in liver transplantation from older donors","volume":"25","author":"Ghinolfi D","year":"2019","journal-title":"Liver Transpl"}],"container-title":["Acta Cir\u00fargica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0102-86502026000101408&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:07:02Z","timestamp":1789128422000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-86502026000101408&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":19,"alternative-id":["S0102-86502026000101408"],"URL":"https:\/\/doi.org\/10.1590\/acb415326","relation":{},"ISSN":["1678-2674","0102-8650"],"issn-type":[{"value":"1678-2674","type":"electronic"},{"value":"0102-8650","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e415326"}}