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A multicenter randomized-controlled trial of hypothermic oxygenated perfusion (HOPE) for human liver grafts before transplantation

Schlegel A, Mueller M, Muller X, Eden J, Panconesi R, von Felten S, Steigmiller K, Sousa Da Silva RX, de Rougemont O, Mabrut JY, Lesurtel M, Cerisuelo MC, Heaton N, Allard MA, Adam R, Monbaliu D, Jochmans I, Haring MPD, Porte RJ, Parente A, Muiesan P, Kron P, Attia M, Kollmann D, Berlakovich G, Rogiers X, Petterson K, Kranich AL, Amberg S, Müllhaupt B, Clavien PA and Dutkowski P.

In this multicenter randomized controlled trial, studying the effect of hypothermic oxygenated perfusion (HOPE) on post-transplant morbidity, livers donated after brain death (DBD) were randomly assigned (1:1 ratio) to either SCS alone (n=85), or SCS followed by 1-2 hours of hypothermic oxygenated perfusion (HOPE, n=85) prior to transplantation. The study shows that while the overall number of reported complications were similar between groups, recipients of HOPE-treated livers experienced a 41% reduction in severe (Clavien-Dindo≥IIIb) complications (6.6% vs 12.0%; RR: 0.59) overall, and a 74% reduction of liver graft-related severe complications (10.1% vs 37.2%; RR: 0.27). Also, no graft failures due to liver-related complications occurred in the HOPE group, while 6 liver-related graft failures occurred in the control group (p=0.004).



“As it is a simple and quick perfusion technique, it [HOPE] can be applied easily after organ transport during recipient hepatectomy”

Schlegel et al 2023



J Hepatol / 2023 / doi: 10.1016/j.jhep.2022.12.030

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