Evidence map›Paper›PMID 42049690›Full record

ArticleArtificial organs2026

Pushing the Limit for Marginal Grafts in the Era of Machine Perfusion: A Tale of HOPE From a Leading Italian Institution.

Gerti Dajti, Giuliana Germinario, Enrico Prosperi, Guido Fallani, Chiara Bonatti, Edoardo Prosperi, Antonio Siniscalchi, Maria Cristina Morelli, Antonietta D' Errico, Matteo Serenari and 7 more

Abstract read
In one paragraph

Article in Artificial organs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

17 authors.

Gerti DajtiDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0002-3074-4524
Giuliana GerminarioIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0002-8019-1956
Enrico ProsperiDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0002-9389-1812
Guido FallaniDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0002-5774-7696
Chiara BonattiDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0003-4203-7824
Edoardo ProsperiIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0002-8021-1160
Antonio SiniscalchiIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0002-8567-3508
Maria Cristina MorelliIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0002-9742-1981
Antonietta D' ErricoDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0003-2747-3732
Matteo SerenariDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0003-1471-8585
Massimo Del GaudioIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0003-2754-1627
Chiara ZanfiIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0002-7141-7386
Federica OdaldiIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0003-2910-2273
Lorenzo MaroniIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0003-4195-3580
Andrea LaurenziIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0002-6847-3379
Matteo CesconDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0003-1715-3794
Matteo RavaioliDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID https://orcid.org/0000-0001-5862-6151

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe advent of machine perfusion (MP) has significantly improved post-liver transplantation (post-LT) outcomes, potentially enabling the use of increasingly marginal grafts and expanding the organ donor pool.

methodsWe present a retrospective cohort study of consecutive adult patients who underwent LT between 2018 and 2023 at a leading Italian institution. The objective was to evaluate outcomes following the use of hypothermic oxygenated perfusion (HOPE) in high-risk grafts.

resultsA total of 507 patients were included in the final analysis, of whom 420 (83%) received extended criteria donor (ECD) grafts. Among ECD grafts, 62 (15%) were from donation after circulatory death (DCD) donors, and 64 (15%) were previously discarded by other centers. HOPE was applied in 248 (49%) cases. Recipients in the HOPE group experienced significantly lower rates of early allograft dysfunction (EAD) (20% vs. 32%, p = 0.007), primary nonfunction (2% vs. 7%, p = 0.017), and severe postoperative complications (Clavien-Dindo grade ≥ 3b) (19% vs. 28%, p = 0.026). Notably, marginal grafts treated with HOPE achieved survival outcomes comparable to those of standard risk.

conclusionsHOPE is associated with improved outcomes in LT using ECD grafts and can enable the safe use of higher-risk organs with acceptable results when performed in experienced centers.

Indexed as

Liver TransplantationOrgan PreservationPerfusionAdultFemaleGraft SurvivalHumansItalyMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTissue Donors

Identifiers

PMID42049690
PMCPMC13397262

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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.