Reich DJ, Mao S, Satish S, Nassar A, Rizzari M, Al-Adra DP et al.
JAMA Surg 2026; 161: 691-702.
Among 219 liver transplant recipients, early allograft dysfunction was less frequent with back-to-back portal venous hypothermic oxygenated perfusion (HOPE) (20.2 versus 37.3 per cent; rate difference −17.1 per cent, 95 per cent confidence interval −27.2 to −7.0; superiority P=0.005), with a lower mean model for early allograft function score (4.28 versus 4.82, P=0.03) and shorter hospital stay (hazard ratio 1.32, 1.01 to 1.73, P=0.04), while 1-year patient and graft survival were comparable between groups.
Comment: A well-powered trial supporting machine perfusion helps improve early posttransplant outcomes among extended-criteria donor livers.
Comment by Jeongyoon (Jenny) Moon, MD
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