Discussion
COLD
The HOPE technique is currently under evaluation within 5 recent or ongoing RCTs conducted in Europe. Our team participated to the Zurich HOPE RCT which compared the HOPE technique to conventional static cold storage in all kinds of brain-dead donor grafts including ECD and normal grafts (NCT01317342) [The proposed RCT would be the first comparative clinical study on liver graft machine perfusion in France and would allow the French transplantation community to become familiar with liver machine perfusion. From an international point of view, it would be the first large RCT assessing the impact of HOPE on ECD from brain-dead donors and would be based on a robust clinical primary endpoint.One limitation of the trial is the choice of definition of the EAD according to Olthoff [