ArticleAnnals of surgery2024
Impact of Back-to-Base Normothermic Machine Perfusion on Complications and Costs: A Multicenter, Real-World Risk-Matched Analysis.
Article in Annals of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
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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
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Hypothermic Oxygenated Perfusion Versus Static Cold Storage in Transplantation of Extended Criteria Liver Grafts: A Systematic Review and Meta-Analysis.Clinical transplantation · 2025Pooled it
- Portal-Venous Hypothermic Oxygenated Perfusion for Liver Transplant: A Randomized Clinical Trial.JAMA surgery · 2026Trial
- A Common Language for Post-Transplant Anastomotic Biliary Strictures: Standardized Endoscopic Outcome Definitions and a Failure-Mode Roadmap.Medicina (Kaunas, Lithuania) · 2026Review
- Real-World Use of Normothermic Machine Perfusion in Liver Transplantation: A Multi-Institutional Experience From the National Organ Perfusion Registry.Clinical transplantation · 2026Article
- Suitability of a Fluorescence Method for Flavin Mononucleotide Determination in Modified HTK-Based Perfusion Solutions During Hypothermic Oxygenated Perfusion of Liver Grafts.Methods and protocols · 2026Article
- Normothermic Machine Perfusion vs. Static Cold Storage for DBD Liver Transplantation in High-MELD Recipients: A Single-Center Retrospective Study.Journal of hepato-biliary-pancreatic sciences · 2026Article
- The effect of normothermic machine perfusion on acute kidney injury following liver transplantation: a propensity score-matched, retrospective, single-centre, cohort study.EClinicalMedicine · 2026Article
- Evolution of out-of-sequence liver allocation, 2019-2024.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- The Impact of Normothermic Machine Liver Perfusion on Early Renal Outcomes After Simultaneous Liver-kidney Transplantation: A Propensity Score-Matched Analysis.Transplantation direct · 2026Article
- Ischemia-free Liver Transplantation: 7-y Experience From a Single-center Cohort in China.Transplantation · 2026Article
- Back-to-base Versus In-transit Machine Perfusion in Donation After Circulatory Death Liver Transplantation: Insights From a National Registry.Transplantation direct · 2026Article
- Transplantation of older DCD livers in the machine perfusion era: a U.S. cohort study.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Outcome reporting for liver transplantation machine perfusion studies: a systematic review.EClinicalMedicine · 2026Review
- Machine perfusion for liver transplantation: opportunities and challenges for the next generation of transplant surgeons.Frontiers in transplantation · 2026Review
- Time as a Therapeutic Ally: The Promise of Long-Term Solid Organ and Tissue Perfusion.Transplant international : official journal of the European Society for Organ Transplantation · 2026Review
- The Role of Machine Perfusion for Liver Transplantation in Children.Pediatric transplantation · 2025Review
- Posttransplant Health-economic Impact of Normothermic Machine Perfusion (Back-to-base Model): Advancing Donation After Circulatory Death Liver Transplants With Improved Outcomes and Reduced Wait Times.Transplantation direct · 2025Article
- Arterialization of the Portal Vein: A Potentially Graft-Saving Strategy to Optimize Veno-Arterial Inflow in Liver Transplantation.Clinical transplantation · 2025Article
- Survey of Early Practices and Perceptions of Liver Machine Perfusion Among US Liver Transplant Surgeons.Transplantation direct · 2025Article
- Transforming the logistics of liver transplantation with normothermic machine perfusion: Clinical impact versus cost.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Article
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Authors and funding
25 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAssess cost and complication outcomes after liver transplantation (LT) using normothermic machine perfusion (NMP).
backgroundEnd-ischemic NMP is often used to aid logistics, yet its impact on outcomes after LT remains unclear, as does its true impact on costs associated with transplantation.
methodsDeceased donor liver recipients at 2 centers (January 1, 2019, to June 30, 2023) were included. Retransplants, splits, and combined grafts were excluded. End-ischemic NMP (OrganOx-Metra) was implemented in October 2022 for extended-criteria donation after brain death (DBDs), all donations after circulatory deaths (DCDs), and logistics. NMP cases were matched 1:2 with static cold storage controls (SCS) using the Balance-of-Risk [donation after brain death (DBD)-grafts] and UK-DCD Score (DCD-grafts).
resultsOverall, 803 transplantations were included, 174 (21.7%) receiving NMP. Matching was achieved between 118 NMP-DBDs with 236 SCS; and 37 NMP-DCD with 74 corresponding SCS. For both graft types, median inpatient comprehensive complications index values were comparable between groups. DCD-NMP grafts experienced reduced cumulative 90-day comprehensive complications index (27.6 vs 41.9, P =0.028). NMP also reduced the need for early relaparotomy and renal replacement therapy, with subsequently less frequent major complications (Clavien-Dindo ≥IVa). This effect was more pronounced in DCD transplants. NMP had no protective effect on early biliary complications. Organ acquisition/preservation costs were higher with NMP, yet NMP-treated grafts had lower 90-day pretransplant costs in the context of shorter waiting list times. Overall costs were comparable for both cohorts.
conclusionsThis is the first risk-adjusted outcome and cost analysis comparing NMP and SCS. In addition to logistical benefits, NMP was associated with a reduction in relaparotomy and bleeding in DBD grafts, and overall complications and post-LT renal replacement for DCDs. While organ acquisition/preservation was more costly with NMP, overall 90-day health care costs-per-transplantation were comparable.
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