Bridge to Life's VitaSmart HOPE Technology Shows Promise for Expanding Liver Transplant Donor Pool
Key Insights
New data from the 2026 International Liver Transplantation (search) Society Congress demonstrates that Bridge to Life's VitaSmart (search) Hypothermic Oxygenated Perfusion (HOPE) technology improves utilization of marginal donor livers including steatotic and older organs.
Studies show HOPE enables higher utilization rates of previously discarded liver grafts from controlled donation after circulatory death, increasing from 1% to 5.8% when complications arise during normothermic regional perfusion.
Research confirms that prolonged HOPE up to 24 hours maintains mitochondrial function and structural integrity comparable to standard short-duration perfusion, providing logistical advantages for transplant scheduling.
Bridge to Life Ltd (search). announced new clinical data demonstrating that its VitaSmart (search) Hypothermic Oxygenated Perfusion (HOPE) technology significantly expands the utilization of marginal donor livers while preserving mitochondrial function. The studies, presented at the 2026 International Congress of the International Liver Transplantation (search) Society (ILTS) in Geneva, Switzerland, strengthen the case for broader adoption of HOPE technology across transplant centers in the United States and Europe.
HOPE Technology Expands Donor Acceptance Criteria
A multicenter matched-cohort study conducted across Spain's leading transplant centers examined the use of HOPE in high-risk liver grafts involving extended-criteria donors and prolonged cold ischemia time. The research included institutions such as Bellvitge University Hospital in Barcelona, Virgen del Rocío University Hospital in Sevilla, and six other major transplant centers.
The researchers concluded that dynamic perfusion with hypothermic oxygenation in cases of steatotic grafts and older donors achieves outcomes comparable to static cold storage for renal scintigraphy, early allograft dysfunction (search), and ischemic cholangiopathy (search). Notably, HOPE resulted in lower 90-day mortality rates. Risk factors for Signal Recognition Particle (SRP) were identified as recipient age over 65 years and preservation time greater than six hours.
Recovery of Previously Discarded Organs
Researchers from Hospital Vall Hebron (search) in Barcelona analyzed HOPE's effectiveness in salvaging organs that encountered complications during normothermic regional perfusion (NRP) in controlled donation after circulatory death (cDCD) livers. The implementation of HOPE facilitated a dramatic increase in utilization rates of liver grafts from cDCD that developed complications during NRP, rising from 1% to 5.8%. Without HOPE, these grafts would have been deemed unsuitable for transplantation.
Extended Perfusion Maintains Organ Viability
Cleveland Clinic Foundation (search) researchers investigated the safety and feasibility of prolonged HOPE up to 24 hours, comparing mitochondrial function, metabolic stability, and downstream injury response with standard short-duration HOPE. When comparing four hours of HOPE with 12 hours of HOPE use, researchers found no significant differences in mitochondrial injury or function markers, including perfusate flavin mononucleotide (FMN) levels.
The longitudinal analysis confirmed stable profiles over time, demonstrating sustained metabolic integrity. The findings support that prolonged HOPE up to 24 hours maintains mitochondrial function and structural integrity comparable to standard short-duration perfusion. Extended perfusion time provides major logistical advantages, allowing daytime transplantation, improved organ allocation efficiency, and promoting wider clinical implementation.
FMN Emerges as Viability Biomarker
In a separate Cleveland Clinic study examining donor serum FMN as a metabolic signature of graft quality, researchers found that donor serum FMN represents the metabolic quality of organs, providing objective assessment before procurement. The upfront mitochondrial analysis in organ donors correlates with tissue inflammation, fibrosis, and senescence at donation.
The researchers concluded that donor FMN quantification could serve as a rapid, objective biomarker to guide organ acceptance, allocation, and tailor preservation strategies, potentially decreasing the upfront donor decline rate.
Clinical Impact and Market Position
"FDA clearance of VitaSmart (search) established Bridge to Life as the first company to bring HOPE to the U.S. market as a cleared platform for liver transplantation (search)," said Don Webber, president and CEO of Bridge to Life Ltd (search). "These new ILTS data reinforce that HOPE is not simply a preservation strategy—it is a tool for organ recovery, viability assessment, and better transplant decision-making."
The company positions its technology as enabling a transition from preservation toward precision transplantation by extending the use of marginal donor organs and preserving mitochondrial integrity. Bridge to Life offers a portfolio of organ preservation technologies including Belzer UW, EasiSlush, and the VitaSmart (search) Hypothermic Oxygenated Perfusion System.