This article explores the protective mechanisms and current clinical evidence of Hypothermic Oxygenated Machine Perfusion (HOPE) in preventing post-transplant cholangiopathy, particularly in liver grafts from Donation After Circulatory Death (DCD) donors. The review highlights that ischemia-reperfusion injury (IRI) is a key contributor to biliary complications such as non-anastomotic strictures (NAS). HOPE, through its unique ability to recondition mitochondria and prevent oxidative damage, significantly reduces the risk of these complications. HOPE also improves bile production and protects cholangiocytes (biliary epithelial cells) by mitigating inflammation and fibrosis post-transplant.
Schlegel A, Porte R, Dutkowski P. Protective mechanisms and current clinical evidence of hypothermic oxygenated machine perfusion (HOPE) in preventing post-transplant cholangiopathy [published correction appears in J Hepatol. 2022 Sep;77(3):898. doi: 10.1016/j.jhep.2022.06.003]. J Hepatol. 2022;76(6):1330-1347. doi:10.1016/j.jhep.2022.01.024
