{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:22:05Z","timestamp":1787566925694,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:00:00Z","timestamp":1787356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gift of Life Transplant Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Normothermic regional perfusion (NRP) is an effective technique to improve recipient outcomes. However, no valid methods for determining liver viability exist. Identifying relevant biological markers with clinical correlation to liver viability and recipient clinical outcomes is imperative to improve decision-making. Materials and Methods: Fifty-four donors undergoing NRP and their recipients were included. FMN was measured at the start, 1 h, and end of NRP. Lactate was measured at the start, 30, 60, and 90 min of NRP. Primary outcomes were early allograft function using the early allograft dysfunction (EAD) criteria and the model for early allograft function (MEAF). Secondary outcomes included the association with donor warm ischemia time (DWIT), stratified by 30 min. Spearman\u2019s rho assessed correlations. Results: Forty (74%) livers were transplanted, with 5 (12.5%) recipients developing EAD and the mean MEAF score was 3.13 (1.49). FMN at all time points was significantly greater in the EAD group compared to the non-EAD group and was significantly correlated with the MEAF score (Peak FMN: rho = 0.507, p = 0.001). FMN during perfusion did not differ between DWIT &lt; and \u226530 min. Lactate levels were similar across all groups and did not discriminate for adverse allograft outcomes. However, lactate levels during perfusion were higher in the DWIT \u2265 30 min group. Conclusions: These findings suggest that during NRP, elevated FMN, but not lactate, is associated with early allograft function.<\/jats:p>","DOI":"10.3390\/medicina62091622","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T08:03:41Z","timestamp":1787558621000},"page":"1622","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association of Flavin Mononucleotide and Lactate During Normothermic Regional Perfusion with Post-Transplant Liver Outcomes: An Exploratory Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0307-527X","authenticated-orcid":false,"given":"Rapha\u00ebl M. J.","family":"Fischer","sequence":"first","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"},{"name":"Erasmus MC Transplant Institute, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1641-8739","authenticated-orcid":false,"given":"Claire","family":"Cywes","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4048-4757","authenticated-orcid":false,"given":"Olivia","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9400-3506","authenticated-orcid":false,"given":"Nicolas","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sardar","family":"Din","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5450-6398","authenticated-orcid":false,"given":"Tobenna","family":"Ibeabuchi","sequence":"additional","affiliation":[{"name":"School of Medicine, Meharry Medical College, Nashville, TN 37208, 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M.","family":"Sonnenberg","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4525-5827","authenticated-orcid":false,"given":"Matthew H.","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7411-9839","authenticated-orcid":false,"given":"Samir","family":"Abu-Gazala","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2762-6535","authenticated-orcid":false,"given":"James F.","family":"Markmann","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5181-7502","authenticated-orcid":false,"given":"Kim M.","family":"Olthoff","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2162-095X","authenticated-orcid":false,"given":"Abraham","family":"Shaked","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick","family":"Vyas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8694-1124","authenticated-orcid":false,"given":"Marty","family":"Sellers","sequence":"additional","affiliation":[{"name":"Gift of Life Donor Program, Philadelphia, PA 19123, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1131-027X","authenticated-orcid":false,"given":"Jeroen","family":"de Jonge","sequence":"additional","affiliation":[{"name":"Erasmus MC Transplant Institute, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8928-4630","authenticated-orcid":false,"given":"Keyue","family":"Sun","sequence":"additional","affiliation":[{"name":"Transplant Center, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9385-9847","authenticated-orcid":false,"given":"Andrea","family":"Schlegel","sequence":"additional","affiliation":[{"name":"Transplant Center, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8682-972X","authenticated-orcid":false,"given":"Peter L.","family":"Abt","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1001\/jamasurg.2024.0520","article-title":"US Liver Transplant Outcomes After Normothermic Regional Perfusion vs Standard Super Rapid 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