Bridge to HOPE Trial       Economic Benefits of HOPE

Bridge to HOPE study published in JAMA Surgery >

HOPE has demonstrated superior clinical outcomes vs SCS in both DBD and DCD liver transplantation.
Cochrane Review 2023: HOPE vs. SCS1

DBD & DCD:
IMPROVED graft survival

HR 0.45; 95 % CI 0.23 – 0.87
P = 0.02

ECD-DBD: LOWER number
of serious adverse events

OR 0.45; 95 % CI 0.22 – 0.91
P = 0.03

DCD: REDUCED ischemic
biliary complications

OR 0.31; 95 % CI 0.11 – 0.92
P = 0.03

Economic Analysis

  • Analysis using a Markov-decision based model comparing the costs of liver transplantation using back-to-base HOPE vs SCS
  • Data from 1-year follow-up of the Bridge to HOPE trial with Economic inputs from published literature and data provided by the Vizient corporation2
  • Device: VitaSmart™ HOPE System

Estimated cost savings of treatment and outcomes

The potential cost benefits with HOPE were observed using ECD grafts, including 25% DCD grafts, a group with increased risk of complications and worse long-term outcomes in liver transplantation.4

Potential economic benefit of HOPE: These findings in perspective2

  • HOPE for a minimum 1.5 hours at the recipient hospital reduced the cost of LT by shortening the index hospitalization and decreasing late complications (BCs, graft failure and death).
  • These potential cost benefits with HOPE were observed using ECD grafts, included 25% DCD grafts, a group with increased risk of complications and worse long-term outcomes in liver transplantation.4
  • Potential additional benefits of HOPE may include:
    • Increased volume of grafts available for liver transplantation
    • Reduced staff overtime

Abbreviations:

DBD: donation after brain death; DCD: donation after circulatory death; ECD: extended-criteria donor; GS: graft survival; HOPE: hypothermic oxygenated machine perfusion; HR: hazard ratio; LOS: length of stay; OR: odds ratio; Re-LT: retransplantation; RCT: randomized clinical trial; SCS: static cold storage

References:

  1. Tingle SJ, et al. “Machine perfusion in liver transplantation.” Cochrane Database Syst Rev. 2023;9(9):CD014685. Machine perfusion in liver transplantation – Tingle, SJ – 2023 | Cochrane Library
  2. Axelrod DA, Reich D, Schnitzler M. “Economic Benefit of Hypothermic Oxygenated Liver Perfusion.” Poster presentation at American Transplant Congress 2024. June 1–5, 2024. Philadelphia, PA, USA. PowerPoint Presentation
  3. Reich D, et al. “Success of Ex Situ End Ischemic Hypothermic Oxygenated Perfusion (HOPE) Prior to Liver Transplantation – The Bridge to Hope Pivotal Multicenter Randomized Controlled Clinical Trial on the Safety and Effectiveness of the VitaSmart Liver Machine Perfusion System (clinicaltrials.gov: NCT05045794).” Presented at American Transplant Congress 2024. Philadelphia, PA, USA. June 1-5, 2024. atc-late-breaker-2024.pdf
  4. Pandya K, et al. “Differential Impact of Extended Criteria Donors After Brain Death or Circulatory Death in Adult Liver Transplantation.” Liver Transpl. 2020;26(12):1603-1617. Differential Impact of Extended Criteria Donors After Brain Death or Circulatory Death in Adult Liver Transplantation – PubMed

VitaSmart™ is available in all countries accepting the CE mark. VitaSmart Hypothermic Oxygenated Perfusion System has received clearance from the FDA. Pending clinical evaluation and regulatory clearance in all other countries.

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