HOPE Perfusion (Hypothermic Oxygenated Perfusion)
HOPE is a different perfusion strategy from NMP. Instead of keeping the liver at body temperature (normothermic), HOPE perfuses it with oxygenated solution at cold temperatures — typically 8-12°C — for a period of time before transplant.
The mechanism is well-described in the literature:
- HOPE is thought to "recharge" mitochondrial function in the donor liver before reperfusion in the recipient.
- It has been associated with reduced ischemia-reperfusion injury and lower rates of certain post-transplant biliary complications, particularly in DCD (donation after circulatory death) grafts.
- HOPE is shorter-duration than NMP — usually 1-3 hours of oxygenated cold perfusion, not multi-hour normothermic preservation.
Some programs use HOPE selectively for DCD livers; others combine HOPE with NMP in sequence. Adoption varies center by center.
If your center offers HOPE, that signals an active interest in protocols designed to safely use a wider range of donor livers (especially DCD).
Educational only — clinician review pending. Not medical advice. Your transplant team has the final word.