ReviewNature protocols2025
'Back-to-base' combined hypothermic and normothermic machine perfusion of human donor livers.
Review in Nature protocols, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed.
- Portal-Venous Hypothermic Oxygenated Perfusion for Liver Transplant: A Randomized Clinical Trial.JAMA surgery · 2026Trial
- A diagnostic accuracy study of mitochondrial FMN during hypothermic oxygenated perfusion to guide liver utilization and avoid normothermic assessment.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Article
- Simplified ischemia-free liver transplantation with continuous normothermic machine perfusion.Nature protocols · 2026Review
- The evolution of liver graft preservation strategies in liver transplantation.Hepatobiliary surgery and nutrition · 2026Article
- Prolonged Dual Hypothermic Oxygenated Machine Perfusion for Daytime Liver Transplant.JAMA network open · 2026Article
- Time as a Therapeutic Ally: The Promise of Long-Term Solid Organ and Tissue Perfusion.Transplant international : official journal of the European Society for Organ Transplantation · 2026Review
- Advancements inFrontiers in transplantation · 2026Review
- Immune activation during liver machine perfusion is shaped by perfusate composition and is independent of the ischemic injury.Frontiers in immunology · 2026Article
- Static Cold Storage and Machine Perfusion: Redefining the Role of Preservation and Perfusate Solutions.International journal of molecular sciences · 2025Review
- Hepatic ischemia-reperfusion injury: Underlying mechanisms and concepts in liver surgery and liver transplantation.Hepatology (Baltimore, Md.) · 2025Article
- The IDEAL framework for machine perfusion in liver transplantation.Nature reviews. Gastroenterology & hepatology · 2025Article
- Transplantation of Severely Steatotic Liver Grafts After Machine Perfusion Remains a Risky Challenge.Clinical transplantation · 2025Article
- Therapeutic hyperthermia promotes lipid export and HSP70/90 during machine perfusion of human livers.Physiological reports · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The shortage of suitable donor organs has resulted in the use of suboptimal, high-risk, extended-criteria donor (ECD) livers, which are at an increased risk of failure after transplantation. Compared with traditional static cold storage, dynamic preservation by ex situ machine perfusion reduces the risks associated with the transplantation of ECD organs. Ex situ machine perfusion strategies differ in timing (that is, speed of procurement and transport), perfusion duration and perfusion temperature. For 'back-to-base' protocols, the donor liver is statically cold stored during transportation to the recipient hospital (the 'base') and then perfused, instead of transporting the liver using a portable perfusion system. While dual hypothermic (8-12 °C) oxygenated machine perfusion (DHOPE) allows safe prolongation of preservation duration and reduces ischemia-reperfusion injury-related complications, including post-transplant cholangiopathy, normothermic machine perfusion (NMP) at 35-37 °C facilitates ex situ viability testing of both liver parenchyma and bile ducts. Here, we describe a clinical protocol for 'back-to-base' combined DHOPE and NMP, linked by a period of controlled oxygenated rewarming (COR), which we call the DHOPE-COR-NMP protocol. This protocol enables restoration of mitochondrial function after static ischemic preservation and minimizes both ischemia-reperfusion and temperature-shift-induced injury during the start of NMP. The NMP phase allows viability assessment before final donor liver acceptance for transplantation. Sequential DHOPE and COR-NMP may reduce the risks associated with transplantation of ECD livers and facilitate enhanced utilization, thereby helping to alleviate the organ shortage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.