Analysis of 415 DCD Maastricht III livers over an 11-year period in Switzerland showed that 249 were transplanted, with 158 performed at the study institution. One-year patient survival and death-censored graft survival were 87% and 89%, respectively, comparable to standard DBD and DCD transplant benchmarks. Despite 82% of DCD grafts ranking as high-risk or futile by the UK-DCD score, careful mitochondrial assessment during HOPE enabled safe transplantation decisions. Perfusate FMN and NADH analysis provided real-time data on mitochondrial injury, allowing for better graft selection and reduced discard rates. The findings suggest that integrating mitochondrial function screening into machine perfusion protocols can enhance liver transplant outcomes.
Eden J, Breuer E, Birrer D, et al. Screening for mitochondrial function before use-routine liver assessment during hypothermic oxygenated perfusion impacts liver utilization. EBioMedicine. 2023;98:104857. doi:10.1016/j.ebiom.2023.104857
