AT A GLANCE

A new study published in the Annals of Surgery reports that the benefits of dual hypothermic oxygenated machine perfusion (DHOPE) in donation after circulatory death (DCD) liver transplantation persist for up to 5 years.¹

“Transplantation of livers from DCD donors is associated with an increased risk of non-anastomotic biliary strictures (NAS),” explain study authors van Rijn et al. “DHOPE of donor livers before transplantation has been shown to reduce the incidence of symptomatic NAS and acute cellular rejection (ACR) within 6 months, but long-term results are unknown. The aim of this study was to assess the 5-year incidence of NAS and ACR in the DHOPE-DCD Trial.”

For study purposes, recipients of DCD livers in six European centers were randomly assigned to receive the liver either after DHOPE (machine perfusion group, n = 78) or after conventional static cold storage (control group, n = 78). The primary endpoint was the incidence of NAS at 5-year follow-up, while secondary endpoints included ACR, graft, and patient survival.

According to the authors, after 5 years of follow-up, the incidence of NAS was significantly lower in the machine perfusion group than in the control group (14% vs. 26%). Further, in patients with immune-mediated disease, who are at increased risk of ACR, the rate of ACR was significantly lower in the machine perfusion group (0% vs. 32%).

“The short-term benefits of DHOPE in DCD liver transplantation persist up to 5-year post-transplant, with significant reductions in [the] incidence of NAS, and ACR in high-risk patients, compared [to] conventional static cold storage,” conclude the authors.

Reference

1.     van Rijn R, Endo C, Küçükerbil EH, et al. Long-term follow-up after hypothermic oxygenated machine perfusion in DCD liver transplantation: results of a randomized controlled multicenter trial (DHOPE-DCD). Ann Surg. 2025;282(5):717–724.