Evidence map›Paper›PMID 40889087›Full record

SynthesisClinical transplantation2025

Hypothermic Oxygenated Perfusion Versus Static Cold Storage in Transplantation of Extended Criteria Liver Grafts: A Systematic Review and Meta-Analysis.

Valberto Sanha, Bruna Oliveira Trindade, Sangeeta Satish, Laura Batista de Oliveira, Omer Faruk Karakaya, Chunbao Jiao, Keyue Sun, Muhammad Ahmad Nadeem, Charles Miller, Koji Hashimoto and 2 more

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Abdominal Organ Transplantation: Noteworthy Literature in 2025.Seminars in cardiothoracic and vascular anesthesia · 2026
    Review
  6. Transplantation of older DCD livers in the machine perfusion era: a U.S. cohort study.Transplant international : official journal of the European Society for Organ Transplantation · 2026
    Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Valberto SanhaCleveland Clinic, Transplant Center, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-5129-3964
Bruna Oliveira TrindadeFederal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
Sangeeta SatishCleveland Clinic, Transplant Center, Cleveland, Ohio, USA.
Laura Batista de OliveiraDepartment of Inflammation & Immunity, Cleveland Clinic, Lerner Research Institute, Cleveland, Ohio, USA.
Omer Faruk KarakayaCleveland Clinic, Transplant Center, Cleveland, Ohio, USA.
Chunbao JiaoDepartment of Inflammation & Immunity, Cleveland Clinic, Lerner Research Institute, Cleveland, Ohio, USA.
Keyue SunDepartment of Inflammation & Immunity, Cleveland Clinic, Lerner Research Institute, Cleveland, Ohio, USA.
Muhammad Ahmad NadeemDepartment of Inflammation & Immunity, Cleveland Clinic, Lerner Research Institute, Cleveland, Ohio, USA.
Charles MillerCleveland Clinic, Transplant Center, Cleveland, Ohio, USA.
Koji HashimotoCleveland Clinic, Transplant Center, Cleveland, Ohio, USA.
Chase J WehrleCleveland Clinic, Transplant Center, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0002-9275-4744
Andrea SchlegelCleveland Clinic, Transplant Center, Cleveland, Ohio, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of extended criteria donor livers (ECD) is becoming more routine in many transplant centers. These organs have higher risks for complications; however, hypothermic-oxygenated perfusion (HOPE) was found to improve outcomes, including graft survival. We aim to assess the effect of HOPE on different types of ECD liver grafts.

methodsA systematic search was conducted of PubMed, EMBASE, and Cochrane databases to identify studies that compared HOPE versus static cold storage (SCS) for ECD. Subgroup analysis on ECD from brain death (DBD-ECD) and circulatory death (DCD) donors, and of randomized controlled trials (RCT) were conducted. Primary endpoints were primary non-function (PNF), early allograft dysfunction (EAD), length of ICU/hospital stay, vascular/biliary complications, retransplantation, and graft survival.

resultsTwelve studies were identified comprising 1833 transplant patients (29% receiving HOPE and 71% SCS). Pooled analysis showed a significant reduction of EAD, 1-year graft failure rate, retransplantation rate, non-anastomotic biliary strictures and Clavien-Dindo Grade ≥ 3 complications favoring HOPE. Subgroup analysis on DBD-ECD grafts yielded lower EAD and shorter length of the hospital stay with HOPE. Further subgroup analysis on DCD grafts demonstrated lower EAD rates, superior 1-year graft survival rates, and reduced NAS in the HOPE group. Finally, analysis including RCTs revealed decreased EAD and retransplantation rates in the HOPE group.

conclusionsReported outcomes after ECD liver transplantation were significantly improved with HOPE compared to SCS alone. This effect was even more pronounced in DCD grafts.

Indexed as

CryopreservationLiver TransplantationOrgan PreservationPerfusionTissue DonorsGraft SurvivalHumansPrognosisdonor after brain deathdonor after cardiac deathextended criteria donorhypothermic‐oxygenated machine perfusionliver transplantationmarginal grafts

Identifiers

PMID40889087
PMCPMC12401077

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Registered trials

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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.