Use of Dual-Hypothermic Oxygenated Machine Perfusion to Recover Extended-Criteria Pediatric Liver Grafts.

The advent of machine perfusion is deeply changing the field of liver transplantation (LT), unveiling a spectrum of unexplored possibilities, both with hypothermic and normorthermic perfusion. The renewed interest for these techniques originated from the necessity of improving preservation of grafts from extended criteria donors, which are now commonplace in everyday clinical practice. Hypothermic oxygenated machine perfusion (HOPE) has been associated with improved outcomes in grafts from donors after circulatory death (DCD) or grafts from extended-criteria donors after brain death (DBD).(1,2).