ReviewTransplantation direct2026
From Preservation to Repair: A Systematic Review of Therapeutic Organ Rehabilitation During Normothermic Ex Vivo Machine Perfusion.
Review in Transplantation direct, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Background: Normothermic ex vivo machine perfusion (NMP) enables active organ rehabilitation rather than passive preservation. While lung perfusion represents the most mature therapeutic paradigm, kidney, liver, and heart applications are emerging. This review examines therapeutic interventions during NMP across these organs to identify shared mechanisms and translational gaps. Methods: Following PROSPERO registration (CRD420251134637), a PRISMA-compliant search of PubMed, Web of Science, and Embase identified 3336 records. After screening, 155 articles underwent full-text review for inclusion of therapeutic delivery during NMP. Data extraction captured intervention characteristics, perfusion parameters, and outcomes across predefined domains. Results: Twenty-one studies met inclusion criteria: kidney (n = 12, 57%), liver (n = 8, 38%), and heart (n = 1, 5%). Models were predominantly human (n = 13, 62%) or porcine (n = 6, 29%). Interventions included pharmacologic agents (n = 12, 57%), cellular/subcellular therapies (n = 6, 29%), defatting protocols (n = 2, 10%), and circuit modifications (n = 1, 5%). Three mechanistic themes emerged: (1) mitochondrial resuscitation via agents such as AP39 preserved ATP and reduced oxidative stress; (2) immune modulation through CD47 blockade or cytokine hemoadsorption attenuated inflammation; and (3) regenerative approaches using mesenchymal stromal cells to repair structural injuries. Molecular improvements were reported in 95% of studies, but functional improvement in only 38%, revealing an outcome translation gap. Only 19% of studies included posttransplant validation. Conclusions: NMP has enabled effective metabolic and inflammatory reprogramming in kidney and liver perfusion, while cardiac applications lag behind. Standardized reporting, organ-specific functional endpoints, and transplant-linked validation are needed to convert currently rejected organs into viable grafts and expand the effective donor pool.
Identifiers
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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.