ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2018
Development of Clinical Criteria for Functional Assessment to Predict Primary Nonfunction of High-Risk Livers Using Normothermic Machine Perfusion.
Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
70 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Normothermic Perfusion Versus Static Cold Storage in Liver Transplantation: A Meta-Analysis of Randomized Trials.Clinical transplantation · 2025Pooled it
- Donor-Related Risk Factors for Normothermic Machine Perfusion in Liver Transplantation: A Meta-Analysis.Liver international : official journal of the International Association for the Study of the Liver · 2025Pooled it
- Biliary Viability Assessment and Treatment Options of Biliary Injury During Normothermic Liver Perfusion-A Systematic Review.Transplant international : official journal of the European Society for Organ Transplantation · 2022Pooled it
- Ex vivo machine perfusion: current applications and future directions in liver transplantation.Langenbeck's archives of surgery · 2021Pooled it
- Hepatic metabolism of 11-oxygenated androgens in humans: an integrated in vivo and ex vivo approach.European journal of endocrinology · 2025Trial
- Transplantation of discarded livers following viability testing with normothermic machine perfusion.Nature communications · 2020Trial
- When Machine Perfusion Falls Short: Identifying Risks of Liver Graft Failure After Normothermic Machine Perfusion.Artificial organs · 2026Article
- Navigating Uncertainty: Characterizing Rebound Lactic Acidosis in Pediatric Normothermic Machine Perfusion.Pediatric transplantation · 2026Article
- Evaluation of Liver Grafts During Machine Perfusion at 20°C via Metabolization of 13C-Methacetin.European journal of clinical investigation · 2026Article
- Proteomic Trajectories of Metabolic and Proteostatic Adaptation During Normothermic Liver Perfusion.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Performance of Predefined Viability Criteria During Prolonged End-Ischemic Normothermic Perfusion of Brain-Dead Donor Liver Grafts.Clinical transplantation · 2026Article
- Normothermic perfusion of human livers for profiling lentiviral vector pharmacokinetics and transduction.Molecular therapy. Advances · 2026Article
- Inferior Long-Term Outcome of Fatty Liver Allografts After Orthotopic Liver Transplantation.Annals of transplantation · 2026Article
- Cellular and Molecular Changes Induced by Various Preservation Temperatures and Methods of Preservation in Renal Grafts and Other Solid Organ Grafts.International journal of molecular sciences · 2026Review
- Revealing the potential of non-transplanted donor organs: a comparative analysis in the Eurotransplant region.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Advancements inFrontiers in transplantation · 2026Review
- Review
- Beyond preservation: future machine perfusion for liver assessment and repair.Nature reviews. Gastroenterology & hepatology · 2025Review
- Dynamic Lactate Clearance Patterns During Normothermic Machine Perfusion Predict Posttransplant Biliary Complications in Donation After Circulatory Death Liver Transplantation.Transplantation direct · 2025Article
- Normothermic machine perfusion in liver transplantation: a bibliometric analysis of the top 100 most cited articles.Annals of medicine and surgery (2012) · 2025Review
10 more citing papers are in PubMed but not listed here.
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Authors and funding
16 authors.
Funding
Abstract
Increased use of high-risk allografts is critical to meet the demand for liver transplantation. We aimed to identify criteria predicting viability of organs, currently declined for clinical transplantation, using functional assessment during normothermic machine perfusion (NMP). Twelve discarded human livers were subjected to NMP following static cold storage. Livers were perfused with a packed red cell-based fluid at 37°C for 6 hours. Multilevel statistical models for repeated measures were employed to investigate the trend of perfusate blood gas profiles and vascular flow characteristics over time and the effect of lactate-clearing (LC) and non-lactate-clearing (non-LC) ability of the livers. The relationship of lactate clearance capability with bile production and histological and molecular findings were also examined. After 2 hours of perfusion, median lactate concentrations were 3.0 and 14.6 mmol/L in the LC and non-LC groups, respectively. LC livers produced more bile and maintained a stable perfusate pH and vascular flow >150 and 500 mL/minute through the hepatic artery and portal vein, respectively. Histology revealed discrepancies between subjectively discarded livers compared with objective findings. There were minimal morphological changes in the LC group, whereas non-LC livers often showed hepatocellular injury and reduced glycogen deposition. Adenosine triphosphate levels in the LC group increased compared with the non-LC livers. We propose composite viability criteria consisting of lactate clearance, pH maintenance, bile production, vascular flow patterns, and liver macroscopic appearance. These have been tested successfully in clinical transplantation. In conclusion, NMP allows an objective assessment of liver function that may reduce the risk and permit use of currently unused high-risk livers.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.