Hypothermic oxygenated and normothermic machine perfusion mitigate innate systemic and hepatic inflammation after liver transplantation.

Hypothermic oxygenated and normothermic machine perfusion reduce neutrophil-driven inflammation and promote immune regulation after liver transplantation, with HOPE showing faster immune normalization.

• Why it matters: Understanding how preservation strategies influence immune responses is crucial to improving liver transplant outcomes and reducing ischemia-reperfusion injury, yet their immunological effects in humans are not well characterized.
• What they did: The study analyzed immune responses in 47 liver transplant recipients using spectral flow cytometry, multiplex immunofluorescence, cytokine profiling, and mass spectrometry across different preservation methods: SCS, HOPE, and NMP.
• The result: Both HOPE and NMP decreased neutrophil infiltration and modulated immune cell phenotypes, with HOPE leading to faster normalization of lymphocytes and systemic neutrophils, thereby reducing inflammation and enhancing immune regulation.