Comparing hypothermic oxygenated and normothermic liver machine perfusion: Translation matters.

Machine perfusion (MP) is a compelling technique to facilitate the safe transplantation of extended-criteria donation (ECD) livers. As evidenced in the recent meta-analysis by Parente et al [1] Parente A. Tirotta F. Pini A. et al. Machine perfusion techniques for liver transplantation - A meta-analysis of the first seven randomized controlled trials. Journal of hepatology. 2023; Abstract Full Text Full Text PDF Scopus (0) Google Scholar , both main paradigms of clinical MP, hypothermic oxygenated perfusion (HOPE) and normothermic machine perfusion (NMP) were reinforced by several randomized controlled trials (RCTs), demonstrating their clinical superiority to static cold storage (SCS). The authors conclude that comparative studies and longer follow-up data are required to facilitate the introduction of routine MP. As discussed by Parente et al [1] Parente A. Tirotta F. Pini A. et al. Machine perfusion techniques for liver transplantation - A meta-analysis of the first seven randomized controlled trials. Journal of hepatology. 2023; Abstract Full Text Full Text PDF Scopus (0) Google Scholar , current differences impairing the comparability between RCTs include the setting of perfusion (continuous vs. back-to-base), donor inclusion criteria (donation after circulatory vs. after brain death, DBD), and technical approaches (dual vs. single cannulation in HOPE). Based on this scientific conundrum, our group was the first to recently initiate a multicenter RCT directly comparing HOPE and NMP in extended criteria donation (ECD)-DBD liver transplantation (NCT04644744), with the primary clinical endpoint of posttransplant complications. Machine perfusion techniques for liver transplantation - A meta-analysis of the first seven randomized-controlled trialsJournal of HepatologyPreviewMachine perfusion is increasingly being tested in clinical transplantation. Despite this, the number of large prospective clinical trials remains limited. The aim of this study was to compare the impact of machine perfusion vs. static cold storage (SCS) on outcomes after liver transplantation. Full-Text PDF Author names in bold designate shared authorship