Machine perfusion is increasingly used not only to support organs during preservation and transport, but also to assess viability, extend decision time and manage higher-risk grafts. The studies below are useful because they make oxygen-delivery, perfusion and graft-function questions measurable.
Background: contemporary liver perfusion practice
International real-world comparison of HOPE and NMP
Population: 954 NMP-treated and 1,202 HOPE-treated grafts.
The study compared contemporary HOPE and NMP practice with risk-adjusted analyses while showing substantial differences in donor-risk profiles and treatment selection.
National Organ Perfusion Registry
Population: 545 NMP liver transplants across nine U.S. centers.
Perfusion practices varied across centers. The study reported a 90-day death-censored graft failure rate of 1.7% and provides a real-world view of NMP logistics and use.
September 2026 evidence update
Hypothermic Oxygenated Perfusion Versus Static Cold Storage
Population: 8 randomized trials, 984 adult liver transplant recipients.
HOPE was associated with lower early allograft dysfunction, primary non-function, major complications and biliary complications. One-year graft survival was comparable, while retransplantation was lower after HOPE.
Why it matters: strong evidence that oxygenated preservation can modify early graft outcomes and ischemia-reperfusion-related morbidity.
High-KDPI kidney machine-perfusion parameters
Population: 71 recipients of kidneys with KDPI ≥85.
Pre-specified flow/resistance groups did not show statistically significant differences in one-year renal function, graft survival or patient survival.
Why it matters: supports testing whether perfusion-device measurements actually predict tissue-level and clinical benefit.
Lung transplantation after thoracoabdominal regional perfusion
Population: DCD lung transplantation comparing 1,364 standard rapid recovery and 261 TA-NRP recipients.
One- and three-year survival were comparable. After adjustment, TA-NRP recipients had lower odds of ECMO use at 72 hours.
Why it matters: extends the research map into regional perfusion, procurement physiology and organ-specific preservation.
Relevance to future oxygen-delivery research
These studies identify a research environment in which oxygen availability, tissue-level injury, perfusion quality, viability and graft function can be measured directly.
For future Precision Oxygen Therapeutics research, the question is whether additional oxygen-delivery capability can be evaluated within established transplantation workflows using organ-specific safety and functional endpoints.
The objective is not to replace transplantation or machine-perfusion systems. It is to test whether a defined oxygen-delivery function can contribute to graft preservation, assessment or recovery.