This phase-I pilot study (HOPE-L trial) is the first to demonstrate the feasibility and safety of hypothermic oxygenated perfusion (HOPE) in living donor liver transplantation with small-size liver grafts. Three LDLT grafts underwent HOPE for at least two hours before implantation. Outcomes showed no graft loss or recipient death over a median 7.5-month follow-up, and the liver graft-related adverse events per recipient were comparable to standard practice. Biochemical markers (FMN and NADH) in the perfusate and tissue differed significantly from static cold preserved grafts, supporting the potential of HOPE to optimize outcomes and mitigate small-for-size syndrome in LDLT with marginal or small grafts.
Pardasani M, Rajasekar JS, Schlegel A, Carvalho MF, Rajalingam R, Narasimhan G, Rammohan A, Rela M. Impact of hypothermic organ perfusion in small grafts in living donor liver transplantation to avoid small-for-size syndrome: safety & feasibility pilot study-phase-I HOPE-L trial. Poster presented at: International Liver Transplantation Society (ILTS) 2024. Houston, TX. Dr Rela Institute and Medical Centre, Chennai, India.
