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Organ perfusion – liver

Unlock the power of flexibility
Liver Assist™

Unlock the power of flexibility

Since its introduction, Liver Assist has emerged as the primary device utilized in the major European trials, with its application documented in over 85 peer-reviewed publications. The system provides clinicians a choice of perfusion protocols, whether it’s hypothermic (HOPE or DHOPE), normothermic, sub-normothermic, or a combination with Liver Assist. These complementary protocols all serve different purposes from improving patient outcomes to increasing organ utilization.

CAUTION: This is an unapproved device limited by Federal (or United States) Law to non-clinical research use only and is not commercially available for sale within the United States. Not available in all markets. Please contact XVIVO for more information regarding availability in your specific region.

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Improving patient outcomes

Improving patient outcomes

Hypothermic oxygenated machine perfusion, HOPE or DHOPE, is widely recognized for its ability to reduce the incidence and severity of ischemia-reperfusion injury (IRI). Liver Assist supports both DHOPE (perfusion of both the portal vein and the hepatic artery) and HOPE (single-sided perfusion of the portal vein only). Published in over 50 peer-reviewed scientific papers, the clinical benefits of hypothermic machine perfusion using Liver Assist is well documented.

  • Patient outcomes following transplantation of HOPE-treated high-risk DCD livers were similar to those of standard DBD livers and superior to untreated DCD-livers up to 5-years after transplantation [1].
  • DHOPE reduced the risk of non-anastomotic biliary strictures by 64% compared to untreated DCD livers [2].
  • 38% shorter ICU stays, 45% shorter hospital stays and lowered overall procedural costs with 13,000 EUR in HOPE-treated DCD livers compared to untreated DCD livers [3].

Extending preservation time

Liver Assist can prolong the duration for which the liver can be preserved as it supports up to 24 hours hypothermic perfusion and up to 6 hours normothermic perfusion. This offers clinics more flexibility in recipient selection and scheduling of the transplant procedure.

“Prolonged DHOPE can improve logistical efficiency, allowing for the optimal utilization of deceased donor livers while maintaining favorable outcomes[1].”

Brüggenwirth et al 2024

Expanding the liver donor pool

Expanding the liver donor pool

One of the more sophisticated protocols that Liver Assist supports is sequential use of DHOPE and NMP. In a recent Cochrane Review[1] on Liver Machine perfusion, Compared to SCS, (D)HOPE was shown to improve liver graft survival, reduce the number of serious adverse events, and reduce damage to the bile ducts. While NMP did not appear to have the same benefits, it does allow for viability assessment of the donor liver prior to transplantation into recipient. Sequential DHOPE and NMP combines the benefits of both perfusion protocols, enabling the safe transplant of otherwise high-risk livers.

For instance, University Hospital Groningen, has established a framework based on clinical data to guide the precise application of different protocols: Schematic overview of liver perfusion protocols used at UMCG. Image adapted from van Leeuwen OB, Porte RJ. Ex situ machine preservation of donor livers for transplantation: HOPE for all?. Br J Surg. 2021;108(10):1139-1141. doi:10.1093/bjs/znab293

  1. Schlegel A, et al. Outcomes of DCD liver transplantation using organs treated by hypothermic oxygenated perfusion before implantation. J Hepatol. 2019 Jan;70(1):50-57;
  2. van Rijn, R., et al., Hypothermic Machine Perfusion in Liver Transplantation – A Randomized Trial. N Engl J Med, 2021. 384(15): p. 1391-1401.
  3. Czigany et al. Hypothermic Oxygenated Machine Perfusion Reduces Early Allograft Injury and Improves Post-transplant Outcomes in Extended Criteria Donation Liver Transplantation From Donation After Brain Death: Results From a Multicenter Randomized Controlled Trial (HOPE ECD-DBD). Ann Surg. 2021 Nov 1;274(5):705-712.
  1. Brüggenwirth et al. Prolonged hypothermic machine perfusion enables daytime liver transplantation – an IDEAL stage 2 prospective clinical trial. eClinicalMedicine, 2024. 68.
  1. Tingle SJ, et al. Machine perfusion in liver transplantation, Cochrane Database of Systematic Reviews 2023

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