This multicentre, randomized controlled trial (RCT), published in the New England Journal of Medicine, studied the effect of dual hypothermic oxygenated perfusion (DHOPE) on the incidence of non-anastomotic biliary strictures (NAS) following transplantation of livers donated after circulatory death (DCD). Patients were randomly assigned (1:1 ratio) to receive a liver preserved either with static cold storage (SCS; n=78) alone, or with SCS followed by a period of DHOPE (n=78) using Liver Assist prior to transplantation. The study demonstrates that end-ischemic DHOPE reduces the risk of developing NAS by 64% (RR 0.36, p=0.03) and led to significant reductions in early allograft dysfunction (EAD; RR 0.61) and post-reperfusion syndrome (PRS; RR 0.43) compared to SCS alone.
“The cumulative number of treatments for non-anastomotic biliary strictures was lower by a factor of almost 4 after machine perfusion, as compared with control.”
Van Rijn et al, 2021
N Engl J Med / 2021 / doi: 10.1056/NEJMoa2031532
