Hypothermic oxygenated machine perfusion influences the immunogenicity of donor livers in humans.
Elgosbi, M., et al.Liver Transplantation 2024 [record in progress].
Aims
This observational study aimed to examined the influence of hypothermic oxygenated machine perfusion (HOPE) on the molecular profile of liver allografts as well as on the immune responses induced following liver transplantation.
Interventions
Participants from two randomised controlled trials comparing donor livers randomly assigned to either HOPE or to static cold storage (SCS), were included.
Participants
27 liver transplant recipients.
Outcomes
Molecular and immunogenic profiles of donor livers.
Follow-up
3 months posttransplantation
CET Conclusions
This interesting study investigated the immune responses in 27 liver transplant recipients participating in two randomised controlled trials of hypothermic oxygenated machine perfusion (HOPE) in a single centre. The investigators studied perfusate, liver biopsies and recipient T-cell profiles. They showed that, compared to static cold storage, HOPE livers demonstrated reduction in hepatic immune cells in the perfusate and a reduced activation of the reactive oxygen species pathway. In the recipient, there was upregulation in donor-specific T-reg cell expression following HOPE. These findings are interesting, but as this represents only a small single-centre subset of the overall RCT recruitment, can only be exploratory. The patients included only a very small number of DCD liver recipients. They are, however, in keeping with the reduction in acute rejection rates seen in other studies of HOPE in the liver and kidney.
Trial registration
ClinicalTrials.gov - NCT01317342; ClinicalTrials.gov - NCT02584283