ArticleTransplantation direct2026
Machine-perfused Donation After Circulatory Death Grafts Improve Access to Liver Transplant for Primary Biliary Cholangitis Patients.
Article 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.
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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.
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Primary biliary cholangitis (PBC) is a small-duct cholangiopathy that can lead to end-stage liver disease requiring liver transplantation (LT). Use of donation after circulatory death (DCD) donors in this population has been limited by historic concerns of severe biliary complications and inferior graft outcomes. Recent regulatory approval of normothermic machine perfusion (MP) technology has dramatically improved DCD utilization. However, outcomes of DCD-MP grafts in PBC recipients remain poorly defined. Methods: We performed a retrospective analysis of adult, first-time, deceased-donor LT recipients with PBC using the Organ Procurement and Transplantation Network registry (2015-2025). Recipients were stratified by donation after brain death with cold storage (DBD-CS), DCD-CS, and DCD-MP. Kaplan-Meier and multivariable Cox regression were used to estimate 1-y graft survival and adjusted hazard ratios. Temporal trends were assessed with Poisson regression. Results: Among 1604 recipients, 1311 (82%) received DBD-CS, 141 (9%) DCD-CS, and 152 (9%) DCD-MP. DCD groups had lower median Model for End-stage Liver Disease scores ( Conclusions: DCD-MP achieved 1-y graft survival comparable to DBD-CS in PBC LT recipients, supporting broader consideration of this strategy. Rapid growth in DCD-MP utilization reflects increasing programmatic confidence in contemporary preservation practices for PBC patients.
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