A meta-analysis published in International Journal of Surgery compared hypothermic oxygenated perfusion (HOPE) vs normothermic machine perfusion (NMP) for extended criteria donor (ECD) livers, HOPE vs dual hypothermic machine perfusion (D-HOPE), and whether to pump back-to-base or initiate at the donor site.

Some high-certainty evidence findings include:

• HOPE reduced incidence of early allograft disfunction (EAD), major complications, and acute cellular rejection vs. SCS.
• Long-term HOPE (upper 50% percentile of perfusion to preservation time ratio) was associated with lower risk EAD, major complications, non-anastomotic biliary stricture (NAS), and primary non-function (PNF) vs. SCS.

Overall, the authors concluded that in ECD liver transplantation, HOPE is more effective than NMP for preventing EAD, total biliary complications, non-anastomotic biliary strictures, and acute cellular rejection.

Read the full article here: https://journals.lww.com/international-journal-of-surgery/abstract/9900/ex_vivo_machine_perfusion_of_extended_criteria.2416.aspx