A recent Cochrane review and meta-analysis presented during The 2024 International Congress of the International Liver Transplantation Society (ILTS) revealed significant advantages of hypothermic oxygenated machine perfusion (HOPE) over normothermic machine perfusion (NMP) and ice-box static cold storage (SCS) for livers awaiting transplantation. Conducted by Samuel James Tingle, MD, from Newcastle University, the analysis encompassed seven randomized trials involving 1024 transplant recipients. Results showed that HOPE led to improved graft survival, reduced adverse events, and lower rates of clinically significant ischemic cholangiopathy when compared to SCS.
Dr. Tingle emphasized the superiority of end-ischemic HOPE in providing bett
er outcomes for donation after cardiac death (DCD) or marginal donation after brain death (DBD) liver transplants, highlighting its potential to enhance clinical results significantly. Meanwhile, NMP showed no nota
ble improvement in these outcomes, suggesting the need for further well-powered trials specifically designed to evaluate its utilization benefits.
The meta-analysis utilized standard Cochrane search methods and rigorous data extraction processes to evaluate randomized machine perfusion trials. The findings align with the ongoing Bridge to HOPE study and real-world observations, indicating the potential of HOPE, particularly with devices like VitaSmart, to revolutionize organ preservation methods and improve transplantation outcomes globally.