Bridge to Life’s HOPE clinical trial shows major cost and rejection benefits for liver transplants

Bridge to Life, Ltd. has released new follow-up data from its pivotal Bridge to HOPE clinical trial, further reinforcing the clinical, economic, and immunological advantages of Hypothermic Oxygenated Perfusion (HOPE) in liver transplantation. Presented at the World Transplant Congress (WTC) 2025 in San Francisco, these analyses provide compelling evidence that the HOPE protocol—when used with Bridge to Life’s VitaSmart™ Perfusion System—can significantly reduce healthcare costs, hospital stay duration, and the severity of organ rejection, including steroid-resistant rejection.

How Does HOPE Improve Outcomes in Liver Transplants?

According to presentations delivered by Dr. David Axelrod of University Hospitals Cleveland Medical Center and Dr. David J. Reich of Drexel University, the HOPE protocol significantly outperforms traditional Static Cold Storage (SCS) across a range of critical post-transplant metrics. The updated data builds upon the 12-month follow-up results previously shared in the WTC 2025 plenary session, which already indicated that HOPE provides robust clinical performance in preserving liver grafts and improving transplant outcomes.

Dr. Axelrod’s economic assessment showed that liver transplant patients treated with HOPE experienced shorter initial hospital stays (10.8 days versus 12.9 days for SCS), lower biliary complication rates (20.2% vs. 24.6%), reduced re-transplantation needs (1.8% vs. 4.5%), and fewer deaths (2.8% vs. 3.6%). These benefits translated into an average cost savings of $28,565 per patient in one-year post-transplant care, based on analysis using Centers for Medicare & Medicaid Services (CMS) reimbursement data.

What Does the Data Say About Immunological Outcomes?

Dr. Reich’s sub-analysis focused on immunological complications and revealed substantial reductions in rejection severity. Although the overall incidence of rejection remained similar between groups, the HOPE cohort exhibited significantly fewer cases of moderate to severe biopsy-proven rejection (32% in HOPE vs. 67% in SCS; p=0.033). Most notably, the incidence of steroid-resistant rejection dropped from 43% in the SCS group to just 4% in the HOPE group (p=0.003), signaling a strong immunomodulatory effect.

These findings suggest that while HOPE doesn’t necessarily prevent all rejection events, it does influence the nature and manageability of those events, making them less severe and more responsive to treatment.

Why Are These Findings Important to Hospitals and Transplant Centers?

The economic and clinical implications of this research are especially relevant in the context of the rising number of liver transplants globally and increasing pressure on healthcare systems to improve value-based care. The cost of liver transplantation in the U.S. often exceeds $800,000 per patient, with extended hospitalizations and post-operative complications being major drivers. With payors and providers alike demanding better cost-to-outcome ratios, technologies like the VitaSmart™ HOPE system are gaining traction.

Don Webber, CEO and President of Bridge to Life, Ltd., commented that the new analyses validate the company’s strategy to deliver both clinical excellence and cost efficiency through innovation. He emphasized Bridge to Life’s continued collaboration with Transplant Centers, Organ Procurement Organizations (OPOs), and hospitals to lower the total cost of care while ensuring high-quality outcomes.

Webber noted, “These new findings reinforce our leadership position in transplant innovation. The data confirms that HOPE not only works clinically, but also makes economic sense. We’re proud to be supporting the transplant community with tools that transform outcomes and reduce long-term complications.”

How Does the VitaSmart System Support HOPE?

Bridge to Life’s VitaSmart™ Perfusion System is designed to deliver hypothermic oxygenated perfusion in a controlled, easy-to-integrate manner for use in recipient hospitals. The platform supports machine perfusion for at least 1.5 hours—a time window the study found to be sufficient to achieve measurable reductions in transplant-related costs and complications.

This approach contrasts with SCS, where organs are kept on ice without oxygenation, limiting their resilience to ischemic injury. HOPE, by oxygenating the organ in a cold state, appears to preserve mitochondrial function and reduce the release of inflammatory mediators, which in turn improves graft function and limits immune activation after transplant.

What Are the Broader Industry Implications of the HOPE Trial?

The Bridge to HOPE trial stands out as one of the largest multicenter studies evaluating machine perfusion in liver transplantation to date. Its findings are expected to influence transplant protocols globally, particularly in regions grappling with low organ utilization rates and high discard rates due to suboptimal graft preservation techniques.

HOPE’s promising performance also ties into a larger sectoral trend: the increasing adoption of normothermic and hypothermic machine perfusion technologies in organ preservation. These technologies are being integrated into national transplant programs in Europe, the U.S., and Asia, often in conjunction with new allocation algorithms that prioritize organ quality and recipient matching. Analysts suggest that as reimbursement models evolve toward value-based care, technologies like HOPE will see faster uptake.

What Are Experts and Institutions Saying About These Findings?

While direct analyst commentary on Bridge to Life, Ltd. remains limited due to its private company status, early sentiment within the transplant medicine and surgical communities appears positive. Several transplant professionals have remarked on social media and at WTC 2025 that these findings could be “practice-changing,” particularly the reduction in steroid-resistant rejection—a complication that often leads to prolonged hospitalization and additional immunosuppression.

Institutions with high MELD transplant volumes or limited access to optimal donors may find HOPE especially beneficial, as it supports better outcomes even in high-risk or marginal donor situations. That potential could reshape organ acceptance practices and improve equity in transplant access.

What Comes Next for Bridge to Life and the HOPE Platform?

With mounting clinical and economic evidence in hand, Bridge to Life is expected to pursue broader regulatory, commercial, and clinical integration strategies. In the U.S., the company may seek expanded CMS reimbursement guidance or health technology assessment (HTA) endorsements to facilitate widespread adoption. Internationally, it is likely to focus on securing approvals in key European and Asian markets.

Future trials may evaluate HOPE in other organs, including kidneys or lungs, or explore whether longer perfusion durations lead to further gains. The company may also partner with academic centers to explore HOPE’s mechanistic underpinnings and potential synergy with immunosuppressive regimens.

Analysts watching the organ transplant tech space anticipate an uptick in machine perfusion device investments and M&A activity, driven by this type of strong clinical-economic validation.