NRP and NMP outcomes in US DCD liver transplantation: A UNOS/OPTN registry study

Results from a retrospective, United Network for Organ Sharing (UNOS) /Organ Procurement and Transplantation Network (OPTN) registry study evaluating outcomes with normothermic regional perfusion (NRP) and normothermic machine perfusion (NMP) in 4,632 adults who underwent liver transplantation (LT) with circulatory death (DCD) grafts  in the US between 2022 and 2024, were published in Annals of Surgery by Acuna et al. Propensity score matching was used to control for differences in donor, recipient, and transplant center-related factors. Outcomes assessed were overall survival (OS) and graft survival (GS) at 1 year after transplant.  

Key data: Super-rapid recovery (SRR)-NMP was associated with improved GS (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.32–0.92) vs SRR-static cold storage (SCS). NRP-SCS was associated with improved GS (HR, 0.42; 95% CI, 0.29–0.61) and OS (HR, 0.60; 95% CI, 0.38–0.96) vs SRR-SCS. No significant differences in GS or OS were observed between NRP-SCS and SRR-NMP or NRP-SCS and NRP-NMP 

Key learning: In this study, NRP and NMP were associated with significantly improved GS compared with conventional SRR-SCS, supporting the adoption of NRP and NMP as the new standard of care in DCD LT.