Clinical Protocol for Hypothermic Oxygenated Perfusion (HOPE) and Controlled Oxygenated Rewarming (COR) of Liver and Kidneys

This clinical protocol outlines the application of Hypothermic Oxygenated Perfusion (HOPE) and Controlled Oxygenated Revascularization (COR) to enhance the quality of donor liver and kidney grafts. The protocol is based on international and domestic studies demonstrating reduced biliary complications and early graft dysfunction rates with machine perfusion. HOPE is recommended for organs from donors after circulatory death (DCD) and extended criteria donors (ECD), while COR is used for assessing marginal organs. The protocol includes detailed descriptions of indications, contraindications, technical aspects of perfusion, monitoring, and viability assessment using biomarkers such as flavin mononucleotide, succinate, and markers of apoptosis, necroptosis, and ferroptosis. The authors present their own results, confirming the effectiveness of these methods in reducing complications and improving transplantation outcomes.