Figure 2.

Hypothermic oxygenated machine perfusion (HOPE). First the donor organ is retrieved and transported to the transplant centre in a conventional way. In the transplant centre, the liver is connected to the liver assist device and HOPE is performed. Hypothetically, organ reconditioning with HOPE triggers multiple protective responses leading to decreased oxidative stress, improved energy reserves, reduced cell death. CCS, conventional cold storage; ET, Eurotransplant; ROS, reactive oxygen species. Adapted from Schlegel et al.²⁴