Organ Availability Research Articles

Racial and ethnic disparities in liver transplant access vary within and across transplant referral regions.

Prior studies have demonstrated racial disparities in access to liver transplantation but determinants of these disparities remain poorly understood. We used geographic catchment areas for transplant centers (transplant referral regions, TRRs) to characterize transplant environment contributors to racial and ethnic disparities in liver transplant access. Data were obtained from the Scientific Registry for Transplant Recipients (SRTR) and the National Center for Health Statistics (NCHS) from 2015 to 2021. The primary outcome was the difference in the listing-to-ESLD death ratio (LDR) between Black, Hispanic, and non-Hispanic White patients for each TRR. We accounted for demographics, socioeconomic status, healthcare access, organ availability, and transplant center competition using multivariable linear regression. We examined intra-TRR differences in waitlist composition using Levene's test of variance. Across the 66 included TRRs, Black patients had lower LDRs than White patients in 80% of TRRs, while Hispanic patients had equal or higher LDRs compared to White patients in 56% of TRRs. The majority of variation in racial disparities across TRRs remained unexplained by multivariable models. Disparities were attenuated after excluding patients with HCC-associated mortality. Among the 27 TRRs that contained more than one transplant center, variance across TRRs was statistically significant for Black and Hispanic waitlist composition. We observed substantial geographic variation in the magnitude of racial disparities in liver transplant access across the United States. Findings highlight the need for targeted health equity interventions in regions with high disparities and the development of disparity-sensitive access metrics for transplant centers.

Chronic enrichment affects nitrogen removal in tidal freshwater river and estuarine creek sediments.

Population growth in coastal areas increases nitrogen inputs to receiving waterways and degrades water quality. Wetland habitats, including floodplain forests and marshes, can be effective nitrogen sinks; however, little is known about the effects of chronic point source nutrient enrichment on sediment nitrogen removal in tidally influenced coastal systems. This study characterizes enrichment patterns in two tidal systems affected by wastewater treatment facility (WWTF) effluent and assesses the impact on habitat nitrogen removal via denitrification. We collected intact sediment cores from prevalent habitats in a tidal freshwater river (TFZ; swamp forest) and a tidal estuarine creek system (EST; salt marsh) upstream and downstream of a WWTF outfall, and quantified dissolved gas fluxes across the sediment-water interface during wet conditions in early summer and dry conditions in late summer. Data collected during two synoptic water quality monitoring campaigns complimented laboratory experiments to provide environmental context for biogeochemical processing. The two systems exhibited different enrichment patterns such that the river-dominated TFZ system was characterized by consistently elevated nitrate + nitrite concentrations downstream of the WWTF, whereas precipitation and tidal influence affected nutrient distributions in the EST creek. Downstream sediments in TFZ exhibit an apparent saturation response, while upstream rates may be limited by other factors, such as labile organic matter availability. In contrast, downstream sediments in EST denitrify at higher rates than upstream during wet conditions that may enhance transport of effluent. This work provides information on ecosystem functioning in human-influenced environments and can be of use in developing nature-based solutions, such as water treatment wetlands, for nitrogen removal.

Effect of Different Nitrogen Levels on Growth, Yield, and Nitrogen Use Efficiency (NUE) of Hardinath Hybrid Dhan-1 in Madhesh Province, Nepal

Determining the optimum dose of nitrogen fertilizer application for hybrid rice is vital for boosting production and productivity of rice. Therefore, this study examines the effect of different nitrogen levels on the growth, yield, and nitrogen use efficiency (NUE) of Hardinath Hybrid Dhan-1 in Madhesh Province, Nepal. A field experiment conducted in 2020 at the National Rice Research Program, Hardinath, Dhanusha tested six nitrogen levels (0, 75, 100, 125, 150, and 175 kg ha-1) with four replications under Randomized Complete Block Design during rainy season (June-September). The results showed that nitrogen application significantly improved plant growth and yield, with the highest grain yield (4.99 t ha-1) achieved at 150 kg N ha-1. Increasing nitrogen beyond this level did not further boost yield, indicating that excessive nitrogen does not improve productivity. Nitrogen use and agronomic efficiency were also highest at 150 kg N ha-1, marking it as the ideal rate for optimal rice performance. Soil health, in terms of organic matter and nutrient availability, improved with higher nitrogen levels, while the highest nitrogen uptake occurred at 175 kg N ha-1. In conclusion, 150 kg N ha-1 is recommended as the optimal nitrogen level to enhance hybrid rice yield and NUE, promoting sustainable rice production in the region. These findings highlight the need for optimal nitrogen management to improve crop yield and soil properties while minimizing environmental impact.

Effect of Liquid Fertilizer Based on Local Microorganisms on Soil Fertility and Maize Production

The use of liquid fertilizers based on local microorganisms offers a sustainable solution for enhancing soil fertility and maize production. This study provides a comprehensive literature review of 11 Scopus-indexed articles to examine the effects of these fertilizers on soil health and crop yield. The findings reveal significant improvements in soil organic matter, microbial diversity, and nutrient availability, alongside enhanced maize growth parameters such as germination, biomass accumulation, and grain yield. Despite the variability in results due to environmental factors and application methods, these fertilizers demonstrate the potential to reduce dependency on synthetic inputs and align with sustainable agricultural practices. Challenges related to scalability, economic feasibility, and long-term impacts necessitate further research to optimize their implementation in diverse agricultural settings.

Impact of Crop Residue Management on Soil Health under Rice- Wheat Cropping System in Southern Bihar, India

The study investigates the effects of paddy straw bale management on soil health and the productivity of a rice-wheat cropping system in Southern Bihar. Conducted from 2021 to 2023, the experiment involved four treatments: control (FP), tillage + recommended dose of fertilizer (RDF), zero tillage (ZT) + mulching, and burning + ZT (RDF). Soil samples and crop yields were analyzed to evaluate physico-chemical properties, microbial activities, and economic viability. Results revealed that ZT + mulching significantly enhanced soil properties, including organic carbon, nutrient availability (NPK), and microbial activity, compared to other treatments. Grain and straw yields were highest under ZT + mulching for both rice (80.01 and 84.25 q ha-1) and wheat (53.4 and 57.35 q/ha), with improved plant height, panicle density, and grain quality. Economic analysis indicated the highest benefit-cost ratio under ZT + mulching (3.18 for rice and 2.92 for wheat). This sustainable practice demonstrated its potential to mitigate residue burning's negative impacts, enhance soil health, and boost productivity, offering a viable strategy for long-term agricultural sustainability in the region.

Public knowledge about and attitudes toward organ donation, and public barriers to donate in Jordan: A cross-sectional study.

Organ donation is a critical issue that is receiving greater attention worldwide. In Jordan, the public's knowledge about and attitudes toward organ donation play a significant role in the availability of organs for transplantation. To assess the public knowledge about and attitudes toward organ donation in Jordan. A cross-sectional design was used to collect data from 396 Jordanian citizens via an online self-reported questionnaire. Overall, 396 participants were recruited. Of the entire sample, 93.9% of the participants had heard about and had sufficient knowledge about organ donation but they had limited knowledge about brain death. The most common source of information about organ donation was social media networks. Females were found to score significantly higher than males for attitude. Those who had thought about organ donation or registered their names to donate scored significantly higher in terms of attitudes to donation than their counterparts who had not. The most common reasons for limited organ donation practices in Jordan were a lack of awareness programs and insufficient knowledge in society. Greater public understanding of organ donation appears to be associated with more positive attitudes toward organ donation. Most participants responded positively regarding their attitude toward organ donation as they believed that this action could give another person a chance to live. Moreover, most agreed that they would donate their organs after their death. Otherwise, the participants had limited general knowledge about brain death, and most had not registered their names to donate their organs. These findings indicate the need for public awareness campaigns and educational programs to encourage more people to become organ donors.

Desertification Reduces Organic Carbon Content and Nutrient Availability in Dryland Soils: Evidence From a Survey in the Amu Darya River Basin

ABSTRACTDesertification degrades drylands, undermining ecosystem services and human well‐being as a serious global issue. Assessing desertification impacts on soil organic carbon (SOC) and properties aids in preserving drylands and combating desertification. However, knowledge gaps persist regarding desertification effects on SOC and soil in Central Asia's Amu Darya River Basin. Surveys across ~1000 km in this region showed that desertification decreased SOC by ~52% versus natural vegetation. Desertification also reduced nutrient availability and altered hydrothermal conditions, pH, stoichiometry, and herbaceous richness. In particular, it decreased soil clay and silt while increasing sand content. Regional climate change and prolonged grazing are primary desertification drivers here. These pronounced impacts on soils and vegetation may threaten ecological processes and services. Our findings contribute to dryland restoration efforts and resilience against desertification.

Patterns of siderophore production and utilization at Station ALOHA from the surface to mesopelagic waters

AbstractThe North Pacific subtropical gyre is a globally important contributor to carbon uptake despite being a persistently oligotrophic ecosystem. Supply of the micronutrient iron to the upper ocean varies seasonally to episodically, and when coupled with rapid biological consumption, results in low iron concentrations. In this study, we examined changes in iron uptake rates, along with siderophore concentrations and biosynthesis potential at Station ALOHA across time (2013–2016) and depth (surface to 500 m) to observe changes in iron acquisition and internal cycling by the microbial community. The genetic potential for siderophore biosynthesis was widespread throughout the upper water column, and biosynthetic gene clusters peaked in spring and summer along with siderophore concentrations, suggesting changes in nutrient delivery, primary production, and carbon export seasonally impact iron acquisition. Dissolved iron turnover times, calculated from iron‐amended experiments in surface (15 m) and mesopelagic (300 m) waters, ranged from 9 to 252 d. The shortest average turnover times at both depths were associated with inorganic iron additions (14 9 d) and the longest with iron bound to strong siderophores (148 225 d). Uptake rates of siderophore‐bound iron were faster in mesopelagic waters than in the surface, leading to high Fe : C uptake ratios of heterotrophic bacteria in the upper mesopelagic. The rapid cycling and high demand for iron at 300 m suggest differences in microbial metabolism and iron acquisition in the mesopelagic compared to surface waters. Together, changes in siderophore production and consumption over the seasonal cycle suggest organic carbon availability impacts iron cycling at Station ALOHA.

Narrative review on tissue and organ cryopreservation research related to regenerative medicine: from early attempts to future possibilities

The development of organ transplantation and cryopreservation has transformed modern transplantation and regenerative medicine. This review explores these interlinked fields, focusing on their convergence and mutual influence on modern transplant practices. Initially evolving independently, organ transplantation and cryobiology have advanced in tandem, with each field’s breakthroughs shaping the other. While organ transplantation has made remarkable strides, it remains constrained by the limited availability and preservation of viable organs. Cryopreservation offers a solution, enabling longer-term storage and broader access to organs for transplantation. This review traces the history of organ transplantation, emphasizing milestones that have improved recipient outcomes. It also examines cryopreservation techniques, such as directional freezing and vitrification, which show promise for maintaining tissues and organs over extended periods. However, challenges remain, particularly for preserving large, complex organs. Issues such as ice formation, cellular damage, and rewarming must be addressed to enhance the viability of cryopreserved organs. Key research barriers include the development of non-toxic cryoprotectants, advanced cryogenic equipment for precise temperature control, and anti-rejection therapies. By addressing these challenges, cryopreservation can help tackle critical organ shortages, enabling sustainable and flexible organ banks that improve access to life-saving transplants. The integration of regenerative medicine with cryopreservation could revolutionize transplantation, fostering personalized approaches and improving clinical outcomes. This review underscores the transformative potential of cryopreservation to create reliable organ banks, advance regenerative medicine, and save lives globally.

Autologous Bone Marrow-Derived Mesenchymal Stem Cell Transplantation for Decompensated Post-Hepatitis B Cirrhosis: A Case Report

End-stage liver disease (ESLD) represents the terminal phase of chronic liver injury, characterized by overt clinical manifestations and severe complications that significantly impair the quality of life. The condition often culminates in a variety of symptoms, including jaundice, ascites, and hepatic encephalopathy, which reflect the liver's inability to perform its essential functions. Liver transplantation remains the definitive treatment for ESLD; however, limitations in donor organ availability necessitate exploration of alternative therapeutic strategies. we present a case of a 71-year-old Asian male with decompensated post-hepatitis B cirrhosis, who had a one-year history of hematemesis and melena. Endoscopic evaluation confirmed the presence of esophageal-gastric varices, further corroborating portal hypertension and hypersplenism. This patient underwent treatment with autologous bone marrow-derived mesenchymal stem cell (BM-MSC) transplantation. Following the procedure, the patient demonstrated significant clinical improvement, suggesting the safety and potential feasibility of BM-MSC transplantation for patients with ESLD. The field of BM-MSC transplantation has witnessed significant progress in recent years, emerging as a promising therapeutic approach for ESLD. This innovative treatment modality harnesses the regenerative capabilities of stem cells to promote liver repair and function. Notably, BM-MSCs possess immunomodulatory properties that may mitigate inflammation and fibrosis in the liver, thereby addressing some of the underlying pathophysiology associated with ESLD. This case presentation highlights the potential application of BM-MSC therapy in patients with decompensated cirrhosis. The findings underscore the need for further research and refinement of clinical application techniques to fully realize the broad therapeutic possibilities of BM-MSC transplantation for ESLD. As we advance our understanding of stem cell therapies, it is crucial to conduct larger studies to evaluate long-term outcomes and establish standardized protocols for treatment.

Exploring the current provision of pancreatic transplantations in low- and middle-income countries: Current landscape, challenges, future prospects.

This comprehensive review addresses the global health challenge of disparities in pancreas transplant access, particularly in low- and middle-income countries (LMICs) compared to high-income countries. Despite advancements in surgical techniques and immunosuppression for procedures like simultaneous pancreas-kidney, pancreas-after-kidney, and pancreas-transplant alone, LMICs face significant challenges, including limited infrastructure, financial constraints, and a shortage of skilled medical professionals. Donation after brain death remains constrained by sociocultural barriers. Region-specific analyses highlight progress in Latin America, Asia, Russia, and South Africa, showcasing the regional disparities in access and outcomes. Future prospects involve minimally invasive surgeries, telemedicine for enhanced post-operative care, international collaborations with organizations like the European Union of Medical Specialists, and robust funding networks to improve organ availability. In conclusion, the review underscores the importance of multifaceted strategies to address economic, sociocultural, and infrastructural barriers, aiming to improve accessibility, quality, and effectiveness of pancreas transplantation services in LMICs.

A conceptual model explaining spatial variation in soil nitrous oxide emissions in agricultural fields

Soil emissions of nitrous oxide contribute substantially to global warming from agriculture. Spatiotemporal variation in nitrous oxide emissions within agricultural fields leads to uncertainty in the benefits of climate-smart agricultural practices. Here, we present a conceptual model explaining spatial variation in temporal patterns of soil nitrous oxide emissions developed from high spatial resolution measurements of soil nitrous oxide emissions, gross nitrous oxide fluxes, and soil physicochemical properties in two maize fields in Illinois, USA. In sub-field locations with consistently low nitrous oxide emissions, soil nitrate and dissolved organic carbon constrained nitrous oxide production irrespective of changes in soil moisture. In sub-field locations where high emissions occurred episodically, soil nitrate and dissolved organic carbon availability were higher, and increases in soil moisture stimulated nitrous oxide production. These findings form the ‘cannon model’ which conceptualizes how sub-field scale variation in soil nitrate and dissolved organic carbon determines where increases in soil moisture can trigger high soil nitrous oxide emissions within agricultural fields.

Mitral Transcatheter Edge-to-Edge Repair in INTERMACS 3-4 Profile Patients with Severe Mitral Regurgitation.

Heart transplantation and left ventricular assist device (LVAD) implementation are effective treatments for advanced heart failure (HF), although their use is limited by organ availability and the high incidence of adverse events. The efficacy of mitral transcatheter edge-to-edge repair (TEER) as a bridge to transplantation or as a destination therapy in advanced HF is still debated. A total of 63 patients with INTERMACS class 3 or 4 with contraindications for LVAD and severe functional mitral regurgitation (FMR) were evaluated for TEER implantation eligibility. The primary endpoint was a composite of death, urgent heart transplantation and LVAD implantation at 12 months. A total of 36 patients underwent TEER, while 27 patients received optimal medical therapy (MT) alone. In the intervention group, 35 patients (97%) were discharged alive. In the MT group, two in-hospital deaths occurred, two patients underwent urgent heart transplantation, and three patients were discharged on inotropes. At the 12-month follow-up, the incidence of the primary endpoint occurring was lower in the TEER group (25% vs. 70%, HR 0.25, 95% CI 0.11-0.60, p < 0.01) and the tolerance to neurohormonal therapy was higher (53% vs. 30%, p = 0.03). In advanced HF patients with INTERMACS profile 3 or 4 and severe FMR, TEER on top of optimal MT was associated with a lower incidence of death, urgent heart transplantation or LVAD implantation at 12 months compared to optimal MT alone.

Assessment of Knowledge and Practices of Nursing Personnel While Caring of Brain Dead Patients Potential for Organ Donation

Introduction Organ donation and transplantation is a life-saving procedure for patients with end-stage organ failure, but it depends on the availability of donor organs. Nurses play a major role to provide care to brain-dead patient potential for organ donation and efficient care to increase the organ’s survival. For years many efforts have been made to create awareness in public regarding organ donation but donors are still very less than demand. Most of the recipients are waiting for organs for more than 6–8 years and many died because of the paucity of donors. Hence, knowledge of nursing personnel is extremely important to the success of organ donation. Objective To assess the knowledge and practices of nursing personnel while caring of brain-dead patients potential for organ donation. Methodology A descriptive research design was adopted to carry out the study. The study was conducted among 30 nursing personnel caring for brain-dead patients from the automatic tube compensation ICU and various units of Nehru Hospital, PGIMER, Chandigarh. Nurses were given questionnaires to fill, including a sociodemographic data sheet and a knowledge questionnaire. The practices of caring for brain-dead patients were observed by using an observation checklist, and a total of 30 observations were made. Results The findings of the study revealed that 50% of nursing personnel had good knowledge about the care of brain-dead patients, 32% had average knowledge, whereas 18% had poor knowledge. There were 42 steps/items of practice regarding care of a brain dead patient. Around one third (38%) of the steps were followed by the participants, some of them followed 57% of the steps. Conclusion Only half of the nursing personnel were possessing good knowledge about the care of brain-dead patients and less than half were doing good practices about the care of brain-dead patients; hence, there is a need to educate the nursing personnel regarding caring of brain-dead patients.

Psychological well-being of women with uterine infertility before considering uterus transplantation as a treatment option.

While uterus transplantation offers a promising treatment option for women with uterine factor infertility (UFI), the potential for graft failure and lack of organ availability could have subsequent psychological repercussions for women. Exploring baseline psychological well-being for women with UFI who could become uterine transplant recipients is essential to identify specific psychological challenges to be considered prior to transplantation. UFI can be congenital uterine absence, namely Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), or acquired uterine absence (hysterectomy). To analyse baseline psychological well-being among women with UFI. A survey including demographic data and two internationally validated psychological questionnaires, Depression, Anxiety and Stress Scale (DASS-21),13 and Fertility Quality of Life (FertiQoL), was disseminated to women with UFI. Data from these instruments was compared between groups and then to data that uses these tools in the general infertility population. The study included 39 women (mean age 29.54 years). Higher scores for moderate symptoms of depression, anxiety, and stress were reported for the entire UFI cohort. More women with congenital UFI showed 'severe' symptoms for depression/anxiety, compared to women with acquired UFI. Women with acquired UFI showed poorer FertiQoL scores compared to both women with congenital UFI and to the general infertility population scores in previously published data. Clinicians should consider accessing increased psychological support for women with UFI when discussing fertility options including uterine transplant, and they may need to tailor this support depending on whether the patient has congenital or acquired UFI.

Unlocking the Promise of Liver Perfusion Technologies for Pediatric Transplantation: A State-of-the-Art Review.

Outcomes after pediatric liver transplantation are generally excellent, but the limited avavailability of suitable, size-matched liver allografts remains a significant barrier. Machine perfusion technology has emerged as a promising approach to expand the donor pool, enabling the use of less ideal whole liver grafts, such as livers donated after circulatory death, and enhancing the execution of split liver transplantation. This review examines the application of machine perfusion in pediatric liver transplantation, focusing on two primary techniques: hypothermic oxygentaed perfusion and normothermic machine perfusion. These methods optimize storage, resuscitation, and assessment of liver grafts before transplantation, potentially expanding the range of usable donor organs. The use of machine perfusion allows for the consideration of suboptimal donor livers and facilitates split liver transplantation, both of which could increase organ availability for pediatric patients. Implementation of machine perfusion could also help reduce waiting list mortality by enabling the safe use of a broader spectrum of donor organs. Adoption of machine perfusion in pediatric liver transplantation will require collaborative, multidisciplinary efforts across transplant centers. By fostering cooperative learning and sharing resources. the integration of machine perfusion into clinical practice has the potential to reduce mortality among children awaiting liver transplantation.

Determining effective waste human hair hydrolyzing parameters combination and its typical physicochemical characteristics in synthesizing liquid nitrogenous organic fertilizer

Discarded Human hairs are considered as waste material in most parts of the world and its accumulation causing several environmental problems. However as a potential material resource, human hair has the advantage that it is completely biodegradable, renewable and available in every locality. Thus reutilizing human hair cut discards with a target of extracting a particular major nutrient supply, namely nitrogen, carbon, sulfur and so forth, can create a positive impact on solving soil’s infertility problems and less productivity issues of concerned agrarian communities. This study has tried to develop waste human hair based bio-fertilizer by primarily identify the better performing hydrolyzing mixture rang of formulation (H5), ratio of human hair waste mass to aqueous hydrolyzer mixture usages (1:5), favorable reacting time ( 90 min) and temperature ( 70 oC) values progressively. Then the physicochemical characteristics were analyzed to reveal the resulted final product’s viscosity (~ 76.0 cp.), density (~ 1.17 gm/l), pH (~ pH 9), organic nutrients availability concerning primary Macronutrients (~ 18:0.03:1 N-P-K ratio ), Secondary Macronutrients (~ 0.13:0:7 Ca-Mg-S ratio) and other trace micronutrient constituents; which are considered as requirements for the soil nutrient enrichments and plant growths.

Left Ventricular Assist Device in Advanced Refractory Heart Failure: A Comprehensive Review of Patient Selection, Surgical Approaches, Complications and Future Perspectives.

The management of advanced heart failure (HF) has long posed significant challenges due to its complex and chronic nature. Heart transplantation, while effective, is not always feasible due to the limited availability of donor organs. In this context, long term mechanical circulatory support and mainly left ventricular assist devices (LVADs) have emerged as a vital intervention to fill this gap. LVAD superiority compared to medical therapy for some patients in advanced heart failure has been demonstrated either as a bridge to transplantation or as destination therapy. This literature review provides a comprehensive overview of the effectiveness, challenges, and advancements in the use of LVADs for treating advanced heart failure. It evaluates clinical outcomes associated with LVAD therapy, focusing on survival rates and quality of life improvements. The review synthesizes findings from recent studies, highlighting both the benefits and complications of LVAD implantation, such as infectious risk, thromboembolic events, hemorrhage and device malfunction. Additionally, it explores the latest technological and biomedical advancements in LVAD design, including innovations in biocompatibility, miniaturization, and power management. By examining current research, this review aims to elucidate how LVADs are transforming heart failure treatment and to offer insights into future directions for clinical practice and research.

Influence of Sustainable Agriculture Practices, Water Management, and Organic Seedling Availability on Yields in Bandung Regency Organic Farms

This study investigates the impact of organic seedling availability, sustainable agriculture practices, and water management on the yields of organic farms in Bandung Regency. Using a quantitative approach, data were collected from 230 organic farmers and analyzed using Structural Equation Modeling (SEM) with Partial Least Squares (PLS). The results reveal that all three factors significantly and positively affect farm yields. Water management had the strongest influence, followed by organic seedling availability and sustainable agriculture practices. These findings highlight the critical role of resource management in enhancing the productivity of organic farms. The study suggests that improving access to organic seedlings, promoting sustainable farming techniques, and investing in efficient water management systems can lead to better farm performance and sustainability. The research offers practical insights for policymakers and agricultural stakeholders seeking to optimize organic farming in the region.

Optimized partial freezing protocol enables 10-day storage of rat livers

Preserving organs at subzero temperatures with halted metabolic activity holds the potential to prolong preservation and expand the donor organ pool for transplant. Our group recently introduced partial freezing, a novel approach in high-subzero storage at -15 °C, enabling 5-day storage of rodent livers through precise control over ice nucleation and unfrozen fraction. However, increased vascular resistance and tissue edema suggested a need for improvements to extend viable preservation. Here, we describe an optimized partial freezing protocol with key optimizations, including an increased concentration of polyethylene glycol (PEG) to enhance membrane stability while minimizing shear stress during cryoprotectant unloading with an acclimation period and a maintained osmotic balance through an increase in bovine serum albumin (BSA). These approaches ensured the viability during preservation and recovery processes, promoting liver function and ensuring optimal preservation. This was evidenced by increased oxygen consumption, decreased vascular resistance, and edema. Ultimately, we show that using the optimized protocol, livers can be stored for 10 days with comparable vascular resistance and lactate levels to 5 days, outperforming the viability of time-matched static cold stored (SCS) livers as the current gold standard. This study represents a significant advancement in expanding organ availability through prolonged preservation, thereby revolutionizing transplant medicine.