Document Type

Article

Publication Date

4-22-2026

Abstract

ABSTRACT

2.Structured summary:

Background: Donation after circulatory death (DCD) has expanded the donor pool but introduces an inevitable period of warm ischemia that threatens graft viability. Preservation techniques such as normothermic regional perfusion (NRP) and static cold storage (SCS) aim to minimize this injury and improve transplant outcomes.

Objective: This scoping review identifies and synthesizes published evidence comparing NRP with SCS in DCD organ transplantation, focusing on their respective effects on warm ischemia time, graft function, and early post‑transplant outcomes.

Methods: Following the PRISMA‑ScR framework [23], searches were conducted in MEDLINE, PubMed, Embase, and Scopus for English‑language studies involving DCD organ recovery using either NRP or SCS. All study designs were considered. Data regarding warm ischemia, graft performance, and early transplant results were charted and synthesized narratively by organ type.

Results: Twenty‑four studies met inclusion criteria. Across liver, kidney, heart, and lung transplantation, NRP consistently shortened functional warm ischemia duration and improved early organ function when compared with cold storage alone. The greatest benefits were seen in liver and heart grafts, which exhibited fewer ischemic complications and improved early viability.

Conclusions: NRP reduces warm ischemic injury and improves early transplant outcomes in DCD organ recovery relative to SCS. Although current evidence supports short‑term benefits, further multicenter research with standardized definitions of warm ischemia is needed to confirm long‑term efficacy and clinical applicability.

Download

Share

COinS