Three significant studies exploring the Hypothermic Oxygenated Perfusion (HOPE) technique in liver transplantation are being showcased this week at the 30th Annual Meeting of the International Congress of The Transplantation Society (TTS 2024) in Istanbul, Turkey. The studies aim to assess the safety of HOPE, its efficacy in improving outcomes in redo-liver transplantation, and its potential for evaluating biomarkers of liver viability.
Dr. Damiano Patrono, the principal investigator and head of the Liver Transplant Unit at AOU Città della Salute e della Scienza di Torino, Italy, expressed enthusiasm about the findings. “Our academic research centre has been at the forefront of evaluating the impact of HOPE in several aspects of liver transplantation,” he said. “We continue to be impressed with the value that the use of HOPE brings to increasing the supply of available livers for transplantation, potentially improving access for those in need and reducing waiting times.”
HOPE has gained attention for its ability to preserve liver grafts, making it a promising method in transplantation. The three studies presented include a multicentre cohort study assessing the outcomes of redo-liver transplantation using grafts treated with HOPE, a retrospective analysis on the risk of infection, and a study on the role of circulating cell-free DNA as a biomarker for graft dysfunction.
The first study, titled “Outcomes of redo-liver transplantation using hypothermic oxygenated machine perfusion,” examined the results of redo-liver transplantation (redo-LT) performed on grafts treated with HOPE. It concluded that HOPE may enable redo-LT to achieve graft survival rates comparable to established benchmarks, despite the use of extended criteria donors.
In another study, researchers investigated whether HOPE increases the risk of bloodstream infections in recipients. The findings indicated that the infection rates post-transplant were similar between those who received HOPE-treated grafts and those subjected to static cold storage. Notably, patients in the HOPE group had more positive microbiological samples, primarily from bile or tracheal aspirates, but these were not linked to clinical symptoms.
The third study focused on using circulating cell-free DNA (cfDNA) as a biomarker for graft dysfunction. It aimed to determine if donor-derived cfDNA could effectively monitor graft health post-transplant. The results suggested that when HOPE is used, levels of mitochondrial cfDNA in the perfusate correlated with liver injury and function, indicating its potential as a valuable tool for assessing liver viability.
Don Webber, CEO of Bridge to Life Ltd., which sponsored the studies, remarked, “These Italian studies further support the value that HOPE can contribute to the transplantation community worldwide. We are finalising the one-year follow-up results of our HOPE Trial in the U.S. and look forward to bringing this innovative technology to U.S. transplant centres, organ procurement organisations, and, most importantly, to patients in need.”
The presentations at TTS 2024 underscore HOPE’s transformative potential in enhancing liver transplantation outcomes, reinforcing its significance in the global effort to improve organ donation and transplantation practices.
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